Are You Eligible for Medicaid if You Have Insurance in Maryland?

Are You Eligible for Medicaid if You Have Insurance in Maryland

If you have health or life insurance, you might wonder if you still qualify for long-term care Medicaid.

There’s significant uncertainty around the question, “Are you eligible for Medicaid if you have insurance in Maryland?” You may worry about the potential impact on your finances, healthcare access, and overall well-being if you don’t qualify for long-term care services.

In this article, we’ll answer “Are you eligible for Medicaid if you have insurance in Maryland?” We’ll explore how both life and health insurance can affect your ability to qualify for Medicaid long-term care services.

Understanding Medicaid in Maryland

Long-term care Medicaid (as opposed to ‘Community Medicaid’) is a government-sponsored health insurance program that helps people pay for extended medical and nursing home care. To qualify, you must be a Maryland resident, meet income and asset requirements, and demonstrate a medical need for long-term services.

Income and Asset Limits

Maryland has limits on income and assets to qualify for Medicaid. For income, you must have a monthly income that is less than the cost of care in a nursing facility, which generally means income can’t exceed 300% of the maximum monthly Supplemental Security Income (SSI) benefit.

The asset limit for applicants of long-term care Medicaid is $2,500 in countable assets. Countable assets include resources like your bank accounts, cash, and investments.

Common Situations that May Lead to Needing Long-Term Care Medicaid

  • Alzheimer’s disease or other forms of dementia
  • Stroke or paralysis
  • Severe arthritis or mobility issues
  • Advanced heart disease or respiratory disorders

If you find yourself in one of these situations and are wondering, “Are you eligible for Medicaid if you have insurance in Maryland?” it’s essential to understand the specific requirements in Maryland.

Are you eligible for Medicaid if you have insurance in Maryland? Life Insurance Income and Assets

Is Life Insurance Counted Towards Income?

Maryland uses the Modified Adjusted Gross Income (MAGI) to assess your income level—which considers various income sources including:

  • Wages
  • Salaries
  • Income from insurance policies

Having life insurance does not automatically disqualify you from Medicaid, but the cash value from a policy may count toward your countable assets, which can affect your eligibility.

Is Life Insurance Counted Towards Assets?

Life insurance policies with a cash surrender value above this amount may be considered countable assets which can impact Medicaid eligibility—unless you take steps to spend down or convert assets in a way that complies with Medicaid regulations.

Ultimately, whether your life insurance policy counts toward your asset total significantly affects your Medicaid eligibility. However, the specific effect of your policy on your Medicaid status depends on the type of policy you hold and its value.

Term life insurance policies do not typically affect eligibility, while whole life insurance policies with a cash value may be considered a countable asset.

Are you eligible for Medicaid if you have insurance in Maryland? Health Insurance

Having health insurance does not automatically disqualify you from receiving long-term care Medicaid benefits.

Medicaid is designed to provide health coverage to people with limited income and resources, regardless of their current health insurance status.

However, your health insurance type and specific circumstances can impact eligibility.

Private Health Insurance

If you have private health insurance—through your employer or purchased individually—you may still qualify for Medicaid if your income and assets fall within Maryland’s eligibility guidelines.

In some cases, having health insurance may work in your favor when applying for Medicaid. If your existing insurance covers a portion of your medical expenses, Medicaid may assist with the remaining costs, giving you more comprehensive coverage.

Medicaid as Secondary Insurance

It’s important to note that if you qualify for Medicaid and have other health insurance, Medicaid will typically become your secondary insurance. Your primary insurance will be billed first, and Medicaid will cover the remaining eligible expenses.

To determine your specific eligibility for Medicaid in Maryland, consult with a Medicaid asset protection and elder law attorney, like the dedicated team at PathFinder Law Group.

Medicaid Planning Strategies For Those with Life Insurance

If you have life insurance and require long-term care Medicaid, protecting your assets and qualifying for Medicaid benefits is critical.

Irrevocable Life Insurance Trusts (ILIT)

One option is to transfer the ownership of your life insurance policy to an irrevocable trust, called an irrevocable life insurance trust (ILIT). When you establish an ILIT, the proceeds will not be counted as assets when determining Medicaid eligibility.

Medicaid Compliant Annuities

Another strategy is to use your life insurance policy to fund a Medicaid-compliant annuity, which can convert this asset into an income stream that falls within Medicaid’s requirements.

Work with an experienced professional to ensure that your strategy meets Medicaid’s strict requirements.

Medicaid Planning Strategies For Those with Health Insurance

Coordinate Health Insurance Benefits with Medicaid

One approach is to coordinate your health insurance benefits with Medicaid. By doing so, you can use your private insurance to cover certain expenses while relying on Medicaid for additional support.

To coordinate benefits, speak with a representative at Maryland Health Connection, Maryland’s Medicaid agency.

Spend-Down Programs

Another strategy is to take advantage of Medicaid spend-down programs, allowing you to use excess income on medical expenses to meet financial eligibility requirements. You can use your health insurance to cover some of these expenses, such as deductibles and copayments, while Medicaid covers the remaining costs.

It’s also important to review your health insurance policy to understand what is covered and what is not. If your policy has limitations or exclusions, you may need to explore alternative options, such as long-term care insurance or Medicaid-compliant annuities.

Steps to Apply for Medicaid If You Have Insurance

  1. Gather necessary documentation, including proof of income, assets, and insurance coverage. You’ll need to provide information about your health insurance policy, such as the plan type, premium amount, and coverage details.
  2. Complete the Medicaid application form, which you can obtain from the Maryland Health Connection website.
  3. Disclose your insurance coverage when prompted on the application. Provide details about your policy, including the insurance company, policy number, and other relevant information.
  4. Submit your application along with the required documentation. You can do this in person, by mail, or online.
  5. Attend the Medicaid assessment interview, if required. During this interview, a caseworker will review your application and ask questions about your insurance coverage and other relevant information.

After submitting your application, Medicaid will assess your eligibility and, if approved, you’ll receive notification of your benefits and next steps.

Key Takeaways

  • Having life or health insurance does not automatically disqualify you from Medicaid eligibility in Maryland.
  • Existing health insurance can work in conjunction with Medicaid to provide comprehensive coverage.
  • Life insurance policies may impact Medicaid eligibility depending on their type and cash value.
  • Medicaid planning strategies, such as creating trusts or spending down assets, can help you qualify for benefits.
  • Consult with a Medicaid and elder law attorney to develop strategies to qualify for Medicaid while preserving your assets.

Contact PathFinder Law Group to Start Medicaid Planning Today

To start creating your Medicaid plan today, schedule a risk-free consultation or call us at (443) 579-4529.

Frequently Asked Questions

Can I apply for Medicaid if I have Medicare?

Yes, in Maryland you can apply for Medicaid even if you’re already enrolled in Medicare. Many individuals qualify for both programs (commonly called being “dual eligible”).

Medicaid can cover additional costs not covered by Medicare, such as certain copayments, deductibles, and premiums, providing more comprehensive health coverage.

What happens to my private insurance if I get approved for Medicaid?

If you’re approved for Medicaid, it will typically act as secondary coverage to your private insurance. Your private insurance will pay first for covered services, and Medicaid will then cover any remaining eligible expenses.

Still have questions? Contact us for a risk-free consultation.

About Adam Zimmerman

Adam Zimmerman is known for his unique ability to put people at ease. Within minutes of meeting Adam, his clients realize he is not the stereotypical attorney and is genuinely invested in helping them through their life situations. He is committed to empowering his clients to be decision makers in the process, so they are knowledgeable about the course of action they decide over their affairs.