At some point during your retirement years, you may find that you need the type of care that can only be provided by a long-term care facility. Given the high cost of that care, you may need to turn to Medicaid for help paying your long-term care (LTC) bill. One concern many seniors have when considering Medicaid as an option is the impact applying for Medicaid will have on their spouse who plans to remain in the community. To prevent you from worrying, a St. Lucie Medicaid planning attorney explains the Medicaid Community Spouse Resource Allowance.
Long-Term Care Facts and Figures
Most of us hope to grow old in our own home without ever needing long-term care. Statistics, however, tell us that when we reach retirement age (65) we all have more than a 50 percent chance of needing long-term care (LTC) at some point after that but prior to the end of life. Those odds continue to increase the longer you live. At age 85, you will stand a 75 percent chance of needing LTC before the end of your life. Given those odds, planning for the possibility that you will need to pay for LTC is a wise decision.
The High Cost of LTC
Healthcare costs, in general, are extremely high in the United States. It should come as no real surprise then to find that the cost of LTC is also high. For the year 2018, the average cost of a year in LTC nationwide was about $100,000. Florida residents paid, on average, slightly higher than the national average at $108,000 for that same year. With an average length of stay of about three years, you are looking at an LTC bill of over $300,000. Because neither Medicare nor most private health insurance policies will cover expenses related to LTC, many seniors faced with the need to pay for LTC turn to Medicaid for assistance.
Medicaid Eligibility Basics
To get help from Medicaid with your LTC expenses, you must first qualify for the program. The Medicaid eligibility guidelines impose both an income and a “countable resources” (assets) limit. Typically, a couples’ income and assets are combined for the purpose of determining Medicaid eligibility. If a couple’s assets exceeded the program limit, those assets must be “spent-down” (sold or transferred) until their value drops below the limit. If the need to qualify springs from the fact that one spouse is in LTC, the spend-down requirement would clearly leave the other spouse (referred to as the “community spouse”) with no resources. Fortunately, the Medicaid “Spousal Impoverishment” rules protect a community spouse.
The Community Spouse Resource Allowance
In Florida, Medicaid’s asset limits are $2,000 for an individual applicant, and $3,000 for married couples applying together. Clearly, so a low asset limit could leave the community spouse without resources if allowances were not made. The good news is that if one spouse of a married couple does not require long-term care, they are subject to Florida’s Community Spouse Resource Allowance (CSRA) and may retain $120,900 in assets without impacting their spouse’s Medicaid eligibility.
In addition, the “Minimum Monthly Maintenance Needs Allowance,” or “MMMNA” allows the community spouse to keep part of the institutionalized spouse’s income if the community spouse has a low monthly income. Community spouses may keep between $2,003 – $3,090, depending on their spouse’s income. A community spouse may keep no more than $3,090, but they may keep no less than $2,003 to prevent spousal impoverishment. This allows the institutionalized spouse to transfer some of their income to their partner without penalty if the community spouse makes less than $2,003 a month.
Contact St. Lucie Medicaid Planning Attorneys
To learn more, please join us for an upcoming FREE seminar. If you have additional questions or concerns about the Community Spouse Resource Allowance, or about the often complex Medicaid eligibility requirements in general, please contact the experienced St. Lucie Medicaid planning attorneys at Kulas Law Group by calling (772) 398-0720 to schedule an appointment.