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How to Qualify for Benefits in Iowa

Most people do not have their finances structured in a way that immediately qualifies them for benefits. If, after reading the information below, you feel you would like to qualify for benefits, please contact our office for a free consultation. This is the unique service an elder law attorney can provide: helping you develop and execute a plan to become qualified for benefits, using the laws to your advantage, in the most expedient and cost effective way.

Older mother and daughter laughing together while sitting outdoors.

By the Numbers

Eligibility for Medicaid is based on your Countable Assets and your Gross Income, on a certain date in time. You will need to provide information about all of your assets, whether you own them jointly or with someone else, in addition to your gross income, before any taxes or insurance premiums are taken out. If you are married, you will also submit information about your spouse’s income and assets.

Non-Countable Assets

one vehicle of unlimited value; home and contiguous land; personal property that does not have a marketable collectable value; cash value of a life insurance policy having a face value of more than $1,500; burial plots, headstones, irrevocable funeral contracts secured with life insurance or other assets that are not valued at greater than the funeral contract.

Countable Assets

everything else.

Income Cap for Medicaid Applicant

gross monthly income $2,349 (2020) increases each year.

If your gross income is more than this amount, you will need a Medicaid Assistance Income Trust (Miller Trust).  You can only get this from an attorney.

Countable Asset Limit for the Medicaid Applicant

 $2,000 on the date of claimed eligibility and every month thereafter, in order to remain eligible.  (Note: the 2020 Covid-19 related stimulus check increases the amount of countable assets the Medicaid recipient (not applicant) can have, by the amount of the check, for 12 months following the receipt of the stimulus check.  For example, if a Medicaid recipient received a stimulus check for $1,200 on August 15, 2020, the Medicaid recipient’s resource allowance is raised to $3,200 through August 31, 2021.

Maximum Countable asset limit held by the spouse

(Community Spouse Resource Allowance) on the date of claimed eligibility $128,640 (2020) increases every year.

Minimum Countable asset limit the community spouse

is entitled to is $25,728 (2020) increases every year.   If the total countable resources are less than two times the minimum asset limit, the community spouse will be able to keep the first $25,728, and the rest will need to be restructured so that it is no longer a countable asset.

How the attribution process work

All countable resources are added together and then divided in half. The community spouse can keep half, up to the limit discussed earlier. In the example below, the community spouse can keep the maximum amount allowed by law.

The application process for a married person

The Iowa Department of Human Resources will need to determine the amount of resources that your spouse will be allowed to keep.  To do that, they will want a financial snapshot of the countable and uncountable assets as of the attribution date.   The date of attribution is the first of the month, for the month in which the Medicaid applicant was last at home overnight. 

For example, Bill went to the hospital on February 3, 2020, then went to the care center for skilled care, and then stayed in the care center.  Now it is November 15, 2020, and Mary is asking about Medicaid.  The attribution date is February 1, 2020.  That is the date that the Department of Human Services will use to determine the amount of countable assets that Mary can keep.

Countable Resources on Feb. 1, 2020

Great Bank Savings
Great Bank Checking
Another Bank CDs
Some Credit Union checking
Some Credit Union savings
Financial Co 1 IRA
Financial Co 2 IRA
Financial Co 2 IRA
Life Insurance Cash Value
Amount the Spouse can keep.
 Amount the applicant can keep.
Amount that needs to be restructured

Once we have calculated the amount of resources the community spouse is allowed to keep, the elder law attorney’s job is to educate and inform the decision-makers about the options available to reduce the amount of countable resources by restructuring them into non-countable resources and/or creating an additional income stream for the community spouse. This period is commonly referred to as the “spend down.”

Traditional assistance to “spend down” provided by well-meaning care center staff or social workers may not include all of the options available to you by law, to help your family restructure assets in a way that maximizes the resources your spouse will be able to keep.

These laws are commonly referred to as the “spousal anti-impoverishment” rules, which are part of the Social Security laws.

Getting from Here to There

Once we have determined the amount of assets that need to be restructured, the elder law attorney will

  • Educate you and your decision-makers about the restructuring options available,
  • help decide which options make the most sense to help you reach your goals,
  • settle on a timeline for reaching those goals,
  • provide you with step-by-step instructions for executing the restructure plan
  • connect you with reliable and trusted 3rd parties whose helps is also needed to execute the restructuring plan,
  • serve as your representative with the Iowa Department of Human Services to prepare and submit all initial documentation required,
  • continue to serve as your representative with the Iowa Department of Human Services to respond to follow up questions or document requests during the period where they are trying to decide whether or not you meet the eligibility criteria.
  • communicate the progress in obtaining benefits to the care center
  • review your benefits award letter for accuracy and
  • instruct your decision-maker on how to handle your finances from that point forward, in order to maintain your continuing eligibility for benefits.

If you still have questions,
check out our frequently asked questions.

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