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Medicaid For Institutional Care - For Individuals With No Spouse

What Is Medical Assistance For Institutional Care?

A program to help pay for swing bed, state hospital, or nursing home care when:

  1. you are likely to be there for 30 consecutive days; and
  2. you have limited income and resources.

How Much Of My Income Can I Keep?

An individual in a nursing facility shall be allowed sixty-five ($65) dollars to meet maintenance needs during all full calendar months in which the individual resides in the nursing facility.

An individual in basic care can keep one hundred ($100) dollars.

What Amount Of Resources Am I Allowed To Keep?

You can keep up to $3,000 in countable resources.

What Resources Are Not Counted By County Social Services?

  • Your home, including trailer homes,  if a doctor states you are likely to return to it within six months, or if your minor or disabled child lives in your home.
  • Personal effects, wearing apparel, household goods, furniture and one motor vehicle.
  • Property which is up for sale, but not sold, or property used for earning a living.
  •   Either the SSI burial or ND burial provision

The SSI burial provision provides for the following:

Non co-mingled burial funds identified by title of up to $1500, plus earnings held for the individual and the individual's spouse are excluded from the date of application. Burial funds may consist of revocable burial accounts, revocable burial trusts, other revocable burial arrangements including the value of installment sales contracts for burial spaces, cash, financial accounts such as savings or checking accounts, or other financial instruments with definite cash value, such as stocks, bonds, the cash surrender value of life insurance not excluded, or certificates of deposit. The fund must be unencumbered and available for conversion to cash on very short notice.

The ND Burial Provision provides for the following:

Any pre-need funeral service contracts, prepayments or deposits to a fund which are placed in an irrevocable itemized funeral contract designated by an applicant or recipient for the applicant's or recipient's burial. An applicant or recipient designates a prepayment of deposit for his or her burial by providing funds that must be used for that purpose. Only those prepayments paid by members of the Medicaid unit are considered as burial prepayments.

Amounts that may be designated as irrevocable vary from State to State. When an individual moves to North Dakota from another state, North Dakota Medicaid will honor the burial plan set up in the other state based on the other state’s burial provision.

Earnings accrued on the total amount of the irrevocable itemized burial contract are excluded.

Markers, monuments, and vaults that have been pre-purchased separately from an irrevocable itemized funeral contract are not considered part of a burial plot and are not exempt. These items are countable assets for Medicaid, based on their current market value. A marker or monument that has already been engraved with some of the individual’s information will likely have a reduced value. It may still have a market value; however, the value will be reduced by the cost to resurface the marker or monument. When a double marker has been purchased and one spouse has already passed away, it can be determined that there is no resale value for the marker.

Normally a life insurance policy is countable asset valued at its cash surrender value, however, when a whole life insurance policy is used to pay for an irrevocable itemized burial contract, the whole life insurance policy is exempt. Life insurance that is designated for burial must cover the life of the person for whom it is designated. The following are the steps the individual will need to take for their life insurance to be considered excluded for burial:

1. The individual will need to contact the funeral home of their choosing

2. Change the beneficiary of the life insurance to the funeral home

3. Execute a contract between the individual and the funeral home to indicate the beneficiary of the life insurance cannot be changed, except for the ability to transfer to another licensed funeral establishment or cemetery association.

If an individual has provided verification of their irrevocable itemized burial contract, they will not be required to re-verify the contract on review unless they have changed the funeral home designation.

  • The value of a life estate. 

NOTE* - The County may impute income from your life estate interest.

  • Indian trust land, Indian per capita funds and judgment funds.
  • A burial plot

Who May Apply For Medical Assistance For Institutional Care?

You or any other interested individual may apply for medical assistance on your behalf.

  1. Your guardian
  2. Your Durable Power of Attorney
  3. Your family
  4. Your health care provider
  5. The hospital
  6. The nursing home

All individuals wishing to make an application for Medicaid must have the opportunity to do so without delay.

A prescribed application form must be signed by the applicant or by someone acting responsibly for an incapacitated applicant.

A relative or other interested individual may file an application on behalf of a deceased individual to cover medical costs incurred prior to death.

It is the responsibility of the applicant to provide information sufficient to establish eligibility in each of the months in which Medicaid benefits are requested.

Disclaimer: This information is not legal advice. If you have a legal problem, you should talk to a lawyer and ask for advice about your options.

NDAC 75-02-02.1

Revised April 2021

Published by Legal Services of North Dakota in conjunction with Department of Aging Services - Title III