The Mississippi Elderly and Disabled (E&D) Medicaid Waiver program is designed to help low income elderly and / or disabled individuals that require nursing home care, but would prefer to remain living at home or in their community instead of in a nursing facility. It does so by providing care services and support to individuals and their primary caregivers. Benefits include services such as adult day care, caregiver respite, home health, and home delivered meals.
Medicaid Home and Community Based Services (HCBS) Waivers, such as this one, are approved to service a specific number of individuals. Once that limit has been reached, a wait list is created. As of 2020, it is unclear if a wait list exists.
Mississippi’s E&D Waiver considers multiple factors for eligibility purposes. The following is current for the year 2020.
Age & Functional Ability – while this waiver is open to persons 21 years or older, persons 65 or older are subject to a different impairment requirement. Those 21 – 64 years of age must be disabled as designated by Social Security. Those over 64 need not be fully disabled, but must need the level of care typically provided in a nursing home.
Income – the monthly income limit for a single applicant is $2,349. This amount is equal to 300% of the Federal Benefit Rate (FBR). For married couples, income is considered separately. This is the case when only one spouse is applying for waiver services, as well as if both spouses are applying. If only one spouse is applying, some of the applicant’s income can be transferred to the non-applicant spouse (also referred to as a community spouse or healthy spouse). This is called the Monthly Maintenance Needs Allowance or MMNA, and assures the community spouse has enough money to live on. It also effectively lowers the applicant’s income. The maximum monthly allowance for the non-applicant spouse is $3,216.
Assets – single, widowed, or divorced applicants are permitted up to $4,000 in countable assets. Some assets are considered exempt (non-countable), such as the applicant’s home, given it is valued under $595,000 and occupied by the owner (or his or her spouse), two vehicles, and other personal belongings, such as furniture, clothing, and household furnishings. Up to $6,000 can also be retained for burial purposes and the face value of combined whole life insurances can be up to $10,000. Unlike income, assets of married applicants are considered jointly owned. (Learn more about Medicaid and jointly owned assets here). Married applicants, with both spouses applying for services are able to keep up to $8,000 in assets. Married applicants, whose spouses are not applying, can distribute joint assets to the non-applicants up to a countable resource limit of $128,640. This is called the Community Spouse Resource Allowance. The applicant spouse is still able to keep up to $4,000 in assets.
Asset Transfers – transfers of financial assets that took place in the 60 months preceding application are subject to review. This is done to determine if the applicant simply gave away their assets or sold assets under market value in an attempt to meet the asset limit. It is quite common for applicants to have unknowingly violated Medicaid’s “look-back” penalty rules. Medicaid will penalize these persons by delaying the onset of their Medicaid eligibility for months or even years (thereby forcing them to pay for their own care). Learn more here.
Mississippi residents who exceed the financial limits, but cannot afford their cost of care, are in a difficult position. Mississippi is one of several states that do not offer residents a Medically Needy Medicaid program. The only option for families that find themselves in this situation is to work with a professional Medicaid planner. These individuals can help families qualify for Medicaid by re-organizing their financial holdings, such as creating an income trust, so that the applicant becomes financially compliant with Medicaid limits. Learn more.
Each applicant is assessed and approved for different services under the E&D waiver. The following services are potentially available to all beneficiaries. These are selected to maximize the recipient’s ability to live independent of nursing homes. Unlike many Waivers, these services are not available to be participant directed. In other words, the state chooses the care providers not the participants.
This program, which is administered by the Mississippi Division of Medicaid’s Office of Long Term Care, is available statewide in all Mississippi counties. One can learn more or apply for services from the Elderly and Disabled Waiver by contacting the Division of Medicaid Long Term Care at 800-421-2408. A brochure is available for download here. Additional information can be found on the Mississippi Division of Medicaid website.