Applying for Medical Assistance for Nursing Home Care

Medical Assistance Application Process

In order to apply for Medical Assistance for long term care services, a person must complete the Minnesota Health Care Program’s Application for Payment of Long-term Care Services (DHS-3531). This form can be obtained from www.dhs.state.mn.us.

While the funding comes from state and federal governments, the county administers the medical assistance program, and processes applications

There are 24 questions on the form:

1. The name of the person living in or planning to live in a long term care facility or planning to get services to help the person live at home;
2. Address and phone number;
3. Is the person a U.S. Citizen or U.S. National?;
4. Does the applicant want someone to act on his/her behalf as an authorized representative?;
5. Does the applicant or his/her your spouse have cash, a savings or checking account, money market account or certificates of deposit?;
6. Does the applicant or his/her spouse own or have an interest in an annuity?;
7. Does the applicant or his/her spouse have life insurance, a burial contract or money set aside for burial expenses?;
8. Does the applicant or his/her spouse own or co-own stocks, bonds, retirement accounts, trusts, contracts for deeds or other assets?;
9. Does the applicant or his/her spouse have a vehicle?;
10. Does the applicant or his/her spouse own or co-own a home, life estate, cabin, land, time share, rental property or other real estate?;
11. Did the applicant or his/her spouse create a trust in the last 60 days?;
12. Did the person or his/her spouse buy an annuity, life estate in another person’s home, a promissory note, loan or mortgage in the last 60 months?;
13. Did the person or his/her spouse not accept items or incomes you could have taken such as an inheritance or a pension in the last 60 months?;
14. Did the applicant or his/her spouse sell, trade or give away items or income in the last 60 months?;
15. Has the person worked in the last 30 days or does he/she expect to work next month?;
16. Was the person self-employed in the month he/she applied or does the applicant expect to be self-employed next month?;
17. Did the person get money this month or does he/she expect to get money next month from sources other than work?;
18. What is the person’s monthly expenses?;
19. Does the person have medical expenses?;
20. Is the person getting medical care for an accident or injury that happened in the last 6 years?;
21. Did the applicant buy, exchange or add a rider to a long term care insurance policy on or after July 1, 2006?;
22. Does the person have Medicare, health insurance or long term care insurance now or has the person had coverage in the last 4 months?;
23. Does the applicant have a spouse?; and
24. Does the applicant want to give part of his/her income to any of his/her family members?

The application also requires that a person submit the following information and documents to verify the information in the form:

1. Immigration status;
2. Pay stubs from the last 30 days or a written statement of earnings from the applicant’s employer if he/she does not have pay stubs;
3. Most recent income tax returns and all related schedules or business records if taxes were not filed;
4. A statement from a person or company that sends the applicant income or payments from sources other than work, which includes copies of checks, award letter, tax forms, court order or other documents from the last 30 days;
5. Recent bank statements or written statement from the bank showing a current balance or value of accounts;
6. Property tax statements for all property the applicant owns, including documents showing the amount of mortgages or other amounts owed against the properties;
7. Any burial contracts and statements of goods and services from the company or funeral home that hold the contracts; and
8. Copies of bonds, annuities, trusts, stock ownership statements or other documents showing value of other assets, including documents that show current loan balances owed against the assets.

The purpose of the application is to determine whether based on a person’s income and assets, the person qualifies to receive medical assistance for nursing home care. A single person is allowed to keep no more than $3,000 in available assets to be eligible for medical assistance benefits.

A married person in allowed to keep no more than $3,000 in available assets, but the person’s spouse is allowed to keep a home, one motor vehicle, household goods and personal goods, each with no limit in value, and a basic allowance.

If a person who applies for medical assistance has more assets than this, then the county will require that the person use those assets for medical care before the person is eligible for medical assistance to pay for nursing home care. This is called a spend down of assets to become eligible for medical assistance. A person will not have to sell the person’s home if he/she returns home within 6 months, or he/she plans to return to the home and his/her doctor thinks the person is able to go within 6 months, or certain family members live in the home.

Generally, any income there person makes in excess of the Federal Poverty Guidelines will need to be used to pay for care. Minnesota has some specific variations on this amount.