Eligibility for Medicaid long-term services and supports (LTSS) depends upon financial and functional eligibility criteria that can vary across states and across LTSS subpopulations. The wide variation in how states define eligibility criteria can result in individuals with similar needs and incomes having different experiences accessing home- and community-based services (HCBS). In this session, staff presented an analysis of one aspect of financial eligibility: maintenance needs allowances.
This presentation provided a brief overview of Medicaid eligibility criteria for people with LTSS needs. Staff focused on individuals who are eligible for Medicaid through the special income level pathway because they are subject to post-eligibility treatment of income rules that permit them to retain a portion of their income in the form of a maintenance needs allowance. Staff also presented an analysis of the resources of community-based adults age 65 and older with incomes no greater than 400 percent of the federal poverty guideline, and their household spending relative to maintenance needs allowances.