My last post discussed some of the differences between Medicaid and the Veterans Improved Pension programs with respect to the treatment of assets, trusts and transfers.
The treatment of income is also different among these programs. Here is a chart that will give you these comparisons at a glance.
Income eligibility for Veterans Improved Pension depends on having sufficient unreimbursed medical expenses (UME’s) that can be used to offset the amount of monthly income and bring it down to the Maximum Annual Pension Rate (MAPR). Expenses must exceed 5% of the income including any payments made to a family caregiver. On the other hand, Medicaid has two major types of long-term care programs, and income is treated differently than for the VA program. http://www.benefits.va.gov/pension/
One Medicaid long-term care program is for individuals who are Categorically Needy – their gross monthly income is below $2,163/month, which is a number that changes each year because it equals 3x the federal poverty rate (this is referred to as “the income cap”). If they live at home and receive services under the Medicaid Long-term Care Services and Supports (MLTSS, formerly called GO or Global Options) they do not have to spend down any of that income specifically on medical expenses in order to qualify. If they are in a nursing home (under Institutional Medicaid) or assisted living facility (ALF) under the MLTSS (formerly GO), they basically turn over all of the income to the facility except for limited specific deductions.
The other Medicaid long-term care program is for individuals whose income exceeds the $2,163 income cap. Presently, they can only receive Medicaid benefits in a nursing home, under the Medically Needy program in which unreimbursed medical expenses are paid out of the excess income and then, after certain specific deductions, Medicaid picks up the cost of the nursing home. A replacement program for these applicants is slated to be active as of November 1st, 2014 — but it’s still being developed so this date may move. Under the new plan, the applicant’s excess income will have to be paid over to a Miller Trust and then disbursed in the month of receipt for the health care expenses including facility costs. Read more about that in my earlier posts on Miller Trusts, sometimes called Qualified Income Trusts. http://blog.finkrosnerershow-levenberg.com/wp-admin/post.php?post=1329&action=edit
Be careful when it comes to paying family caregivers! The rules are drastically different under VA Pension and Medicaid. More on that in an upcoming post.
For legal advice and assistance with Medicaid applications and Veterans Benefits, call 732-382-6070