The Medicaid program which pays for nursing home costs and for care in the community is called MLTSS – Medicaid Long Term Services and Supports. An applicant has to meet the specific financial requirements for income and assets (resources). These financial limits get updated every year. Some numbers go up in January, and others in July. This post reviews the numbers that are changing January 1, 2024, and why that matters to you..
“The Income Cap.” The income cap is 3 times the federal SSI benefit rate. SSI is going up to $943/month on January 1. The income “cap” will be $2,829. Why does it matter? A person can receive MLTSS benefits whether the income is above or below the income “cap.” However, if gross monthly income is above the “cap,” there’s no eligibility unless the applicant established a Qualified Income Trust or “QIT” to funnel that excess income through. Read more here from prior posts which talk about the QITs.
Minimum Monthly Maintenance Allowance (MMMNA) to support the applicant’s spouse: The new MMMNA is $2,465 and the housing allowance will be $739.50; maximum total monthly allowance will be $3,853. Why does it matter? If the spouse’s income is less than a certain amount, they can be eligible to receive monthly support from the spouse who receives MLTSS. A formula is used to determine the amount. This is vitally important for low-income spouses who still live in the community.
Community Spouse Resource Allowance (“CSRA”) – ceiling. When an MLTSS application is filed, the spouse’s non-excluded/exempt assets (resources) can’t exceed the spousal resource limit. The new limit is $154,140 or half of what the couple had at the time the ill spouse needed the care, whichever amount is less. Why does it matter? There is usually (not always) a need to “spend down” some of the couple’s assets before an application can be filed. Now, the spouse can retain more assets. As before, the couple should get personal legal advice when designing the spend-down plan so they can take advantage of the laws and preserve as much as possible.
Community Spouse Resource Allowance (“CSRA”) – floor. In low-asset situations, the community spouse doesn’t have to “spend down” below the “CSRA floor,” which is going up to $30,828. Why does it matter? We’ve helped low-asset couples discover that they are already eligible for Medicaid when the nursing home told them they had to keep paying the facility to spend down.
The MLTSS program is full of traps and complicated requirements. If an application is denied, a couple could be left with a staggering bill to pay. Each applicant’s situation has unique factors and there are legal ways to preserve your hard-earned assets. Call us for advice that is tailored to you ………….. 732-382-6070.