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The purpose of the Medicaid program (Title 19, Medical Assistance) is to provide medical care in a skilled care facility for those individuals with limited assets. The amount of assets a person may have to qualify is dependent upon the marital status of the individual. Once approved for Medicaid, the program pays all of the medical expenses incurred by the individual. The program will cover the Medicare deductibles and co-payments even if the person returns to the hospital.

Medicare pays for a maximum of 100 days while a person is in a skilled care facility. This coverage is only available if the person spends three days in a hospital prior to entering a skilled care facility. Medicare pays for all of the expenses incurred in the first 20 days. The next 80 days the individual must pay a deductible of $97 a day. If the patient has a supplemental Medicare policy it will pay the deductible. After the 100-day period Medicare and the supplemental policy pays nothing.

The asset limits to be eligible for Medicaid vary. There are three classes of assets: exempt, non-exempt and unavailable. The following list of assets is for a single applicant unless otherwise noted.

• A. Personal residence. This includes a duplex, farm, or other property that is considered to be a personal residence.
• B. $2,000 in assets
• C. An automobile of any value for a married couple. If applicant is not married then the automobile cannot have a value greater than $4,500.
• D. Life insurance policy with face value not exceeding $1,500.
• E. Burial assets are now considered exempt regardless of the amount and items set aside for burial. This means that the person can have a burial policy or pre-paid funeral expense of any value.

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A married couple, on the other hand, can have all of the above plus an additional amount of exempt assets as follows:
Total Countable Assets

• A. $0 to $50,000 Community spouse asset share - All of the couple's total assets up to $50,000
• B. $50,001 to $100,000 Community spouse asset share - $50,000
• C. Over $100,000 Community spouse asset share - One half of the assets not to exceed $84,120 Application for Medicaid is made at each county's Department of Health and Family Services where the person's skilled care facility is located, not their county of residence.

This article provides a limited amount of information on Medicaid. If you would like a free booklet detailing information on Medicaid (Title 19) in Wisconsin call 800-388-2526 or 414-302-4050.