Medicaid

Medicaid is a medical assistance program designed to provide health care to persons who meet strict financial and medical requirements.

To apply, contact the State Department of Social Services located in your area or county. Most South Dakota counties have a local office that can assist with the application process and answer questions about the various programs.

Several Medicaid programs exist specifically for the elderly. The Long Term Care program provides hospital and nursing home care for people needing services for more than 30 days. A monthly income limit of $1,593 and an asset limit $2,000 exists for this program. A home being used by a spouse or by children, household goods, and one car are not included in the asset limits. In addition, a minimum of $20,000 is protected for the spouse not in long term care.

The Elderly Waiver program allows for in-home care for those who elect to remain home instead of using a nursing home. The limits are similar to those of the Long Term Care program.

The Qualified Medicare Beneficiary program, known as QMB, is used by some seniors to help pay the premium and deductibles that Medicare doesn't cover. It effectively serves as a supplement to Medicare for those who cannot afford Medigap insurance. Again, there are certain income and asset limits in place.

The Special Low Income Medicare Beneficiary program (SLMB) covers Part B Medicare premiums for those who meet less restrictive income limits than QMB.

For the QMB and SLMB programs, asset levels are $4,000 for an individual and $6,000 for couples. Some items are not counted in these limits, including your home, household goods and personal effects. Also not included are one car and irrevocable burial contracts.

Additional Medicare programs do exist, but qualifying seniors usually apply for one of the above programs to work in conjunction with the Medicare program. You might want to contact your local Department of Social Services to inquire about addition Medicaid programs.

For those who do qualify for the above programs, Medicaid covers many health care expenses, and provides payment directly to the provider.

If you receive a bill for a service paid by Medicaid, contact Social Services.

Medicaid "Spend Downs"

Many people have attempted to qualify for Medicaid by giving away their property and assets. This is referred to as Medicaid "spend-down". Under South Dakota law the state can criminally prosecute any person knowingly disposing of assets in order to become eligible for Medicaid. People considering gifts to liquidate their estate for the purpose of qualifying for Medicaid need to make sure those gifts are not in violation of the law.

Before you begin to transfer or manipulate your assets, contact your attorney to make sure you are not in violation of the law. Transfer laws change often, be aware of the rules in effect when you apply for Medicaid.