The thing is, they will look at her assets as well as income. With the recent substantial amount of gift money, she may no longer be eligible for insurance through a social services agency. She might be eligible for Social Security disability, though.
This is the interesting thing.
There is not an asset test for Medicaid, EXCEPT for the aged or disabled.
Aged means 65. Disabled means disabled by SSA's standards, and eligible for social security disability (SSD) or Supplemental Security Income (SSI).
(SSI is different the SSD in this way: it is means tested. You have to be in poverty and have low assets. SSD is based on earnings quarters; you get it if you had a work history and became disabled. Like a SS retirement pension, it does not depend on your assets at all. But SSD and SSI are similar in that you have to be VERY disabled and/or ready for years of fights and lawyers.)
If AE has assets but low income, and she is not certified disabled by the SSA, she does not have an asset test for Medicaid.
If she is certified disabled by SSA, then she has an asset test. Even if she has an asset test, MA won't hold it against her that she can't liquidate immediately. They could put a lien on property she is trying in good faith to sell. But that is not a big deal.
If she is eligible for Medicaid, the state will evaluate her current insurance and pay the premiums if it seems cost effective. Then, Medicaid becomes the payer of her premiums, and her secondary insurance. Often, MA calculates that they will save money paying the insurance.
If the insurance is not a good deal, she will have to pick a Medicaid plan. Those Medicaid Managed care plans have premiums, too, that the state pays to the plans.
Now what about those gifts? Depends. They are income in the month received. Then they become assets and any income derived (interest income) becomes income.
I really don't buy that her medical insurance is that big an issue. I'd have to see the books, lol.
Medicaid is not going to sit quietly while someone hides money. But if she is upfront about potential future money, such as from sale of property, MA can work with her. They won't hold it against her if it's not in her pocket now.
If she is disabled and has an asset test, there are trusts and liens that help with that. People freak when, for example, MA has a lien on Grammie's house because she can't live there anymore and has moved to a nursing home. But truth be told, MA will get a much better price for medical care than anyone else. So the money MA recoups will be a fraction of the amount Grammie would be billed directly.
And, MA would never put a lien on a home occupied by someone with a legit claim to it, like any of the three family members who are not incarcerated.
Can MA be complicated? Yes. Could her lawyers help? Only if that is their intention. They could complicate things by mishandling the G F yourself fund. They could do her a disservice simply by telling her she's screwed instead of telling her to consider Medicaid.
MOO
Edited to add photos.
Aged/disabled MA is also called "non-MAGI." (Don't try to understand.) For those not aged or disabled, it is called "MAGI," but I guess that became so confusing it's just called Medicaid on the attached chart.
The Medicaid chart, if she's not age/disabled, is monochrome and indicates income limits for a few programs like Medicaid. I believe she falls into MA adult, household size 1 limit. That is 138% of the poverty line. The amount changes every year. Currently $1677.00 per month.
If she's disabled (again, a much higher bar than people think- it's not like getting a special parking permit) her income limits and asset limits are indicated. They're not crazy high. And there are ways to legally put aside funds as a plan for self sufficiency- like if she is disabled now but thinks after she will become able to earn money, she can put aside money she needs to make that transition. Takes some honest creativity, and in good faith you can really make a plan to move back to the work world and fund it. The income and asset limits for aged/disabled are printed in blue and back.
MOO