One of the most fundamental, but often overlooked issues when planning for – or evaluating – Medicaid eligibility is this: Medicaid does not alter property rights, contract rights or other legal rights with value. Medicaid simply measures those rights to determine whether they cause an applicant to be eligible or ineligible. In other words, if […]
Each year, most Medicaid eligibility limits are adjusted for inflation. The 2023 Georgia Medicaid income and resource limits are: SSI Medicaid: Income: $914 per month, Countable Resources: $2,000 QMB Medicaid: Income: $1,235 (100% FPL + $20), Countable Resources: $9,090 SLMB Medicaid: Income: $1,478 (120% FPL +$20), Countable Resources: $9,090 CCSP/EDWP/Nursing Home Income Cap: $2,742; Applicant […]
The Medicaid Spousal Impoverishment allowances are updated annually. Below are some of the annual allowance figures we’ve saved. The most current figures are usually posted here. 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 1998 – 2011
The Centers for Medicare and Medicaid Services released the 2023 SSI and Spousal Impoverishment Standards. Among the highlights are the following: Community Spouse Resource Allowance: $148,620 Maximum Monthly Maintenance Needs Allowance: $3,715.50 Income Cap: $2,742 (used to deterine whether a QIT is needed) Individual SSI rate: $914
Another “option” that may be considered in appropriate cases is divorce. Deeming between spouses terminates when the marriage terminates. In most cases, this “option” should be avoided because the emotional turmoil associated with divorce is significant and the CSRA can be set by court order, see § 1396r-5(f)(2)(iv) and (f)(3). Divorce also prevents an applicant […]
MCCA includes a mechanism for increasing both the CSRA and the MMMNA in certain cases. The methods by which this can be effected are described in 1396r-5(e), (d)(5) and (f)(3). Blumberg v. Tennessee Department of Human Resources, 2000 WL 1586454 (Tenn.Ct.App.) was a case where a Community Spouse sought a court adjustment of the default […]
As eligibility is being determined, if the Community Spouse’s monthly income falls below the Minimum Monthly Maintenance Needs Allowance (“MMMNA”), then MCCA contemplates two methods of raising her income up to the MMMNA. First, a portion of the Institutionalized Spouse’s income may be transferred to her to bring her income up to the MMMNA. Second, […]
Income and resources are treated differently. Unlike resources, income is not pooled in determining eligibility; the Community Spouse’s separate income is never considered available to the Institutionalized Spouse. Thus, the standard income eligibility process for one person applies. First, all income earned by the Community Spouse is always unavailable to pay nursing home bills, regardless […]
In Dullard v. Minnesota Department of Human Services, 529 N.W.2d 438, 443 (Minn. App. 1995), Minnesota was allowed to reevaluate eligibility after a couple moved from Illinois to Minnesota. There, Illinois (like Georgia) allowed the Community Spouse to keep the maximum CSRA, while Minnesota (like Tennessee) applied a formula resulting in a lower CSRA. The […]
Some couples might consider reducing the size of the marital estate by giving their resources away. Frequently this is the result when the plan is “home-made.” However, transfers for less than fair market value, including complete and partial gifts) trigger a period of ineligibility. 42 U.S.C. 1396p(c). It does not matter whether the applicant or […]
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