Home and Community Based Waiver Programs:
Individuals Aged 65 and Older

This Utah Medicaid Waiver program assists clients who are at least 65 years old and would be medically appropriate for institutional care to remain in their own home, instead of being placed in an  institution. These clients are eligible for medical services that are not generally available to Medicaid recipients, such as day treatment programs, lifeline, and in-home respite care. Policy follows the institutional policy except that the client is allowed higher income deductions.  The income standard, after allowable deductions, is 100% of the Federal Poverty Level, which is typically adjusted annually.  (The Federal Poverty Level is available on the Internet at http://aspe.hhs.gov/poverty). All of the client's income counts.

Income Eligibility Limits in Monthly Amounts     (as of April 2005)            

Household Size  *Monthly Income   

1     . . . . . . . . . . .    $   798                   

*Countable Income is gross income minus exemptions, allowable disregards, deductions, and earned income expenses. The disregards and deductions are different for each Medicaid program. This means that the “countable income” to decide eligibility for one program will be different than the “countable income” used to decide eligibility for another program. For this program, deduct $125 earned income, spousal and family allowance, health and accident insurance premiums, medical expenses, some shelter costs.

*Spenddown

Medicaid applicants whose income exceeds the monthly income standard may be considered for the Medically Needy program, sometimes referred to as the Spenddown Program.  This program allows a person who is otherwise eligible either to pay "excess" monthly income to the state or to accept responsibility for a portion of their monthly medical bills.

Asset Limits

Nursing home client - $2,000.00

For married persons with a spouse in the home, assets are divided between husband and wife.  All assets are considered to be jointly owned even if only one member of the couple is shown as the owner. Special allowances for burial spaces and funeral plans.  The spouse at home is allowed to keep at least $18,132 of the assets the couple owned when the client entered the Nursing home, and no more than $90,660, as of January 2003. (These amounts are adjusted upwards each January.)

Transfer of Assets

Sanctions apply if either (1) individual or spouse transfers assets within 36 months, or within 60 months if a trust, of application date for Medicaid, or (2) the individual transfers assets at any time after eligibility is determined. Waiver services are not paid during a sanction period.