Although there are many ways to qualify for Medicaid this post will focus on qualifying for Medicaid long-term care benefits. Thus, we will be primarily discussing Medicaid benefits for individuals over age 65 who need long-term care. In addition to attaining age 65 and being in need of long-term care, one must also satisfy income and resource limitations. Here are the basic income rules for single people and married couples in Louisiana.
To qualify for Medicaid, your monthly income must not be greater than $2,163 (2014). This amount is also known as the long-term care special income limit (SIL), and it includes the income of from all sources. If your income is greater than $2,163 per month (2014) but less than the long-term care facility rate (the monthly rate of the nursing home), you may still qualify after certain adjustments are made to your income. This alternate way of qualifying for Medicaid long-term care benefits is called the Spend-Down Medically Needy Program (“spend down”). For example, Boudreaux meets the resource test (discussed in the next blog post), and his monthly income is $2,700 per month. Because his income is greater than the SIL ($2,163 per month in 2014), he does not qualify under the first test. However, if after certain deductions are made to “spend-down” Boudreaux’s income, his monthly income is less than his particular nursing home facility rate (e.g. $5,000), he passes the Spend-Down Medically Needy Program Test. After an individual is eligible for Medicaid, a portion of the institutionalized spouse’s income is applied to the cost of care. This amount is the Patient Liability Amount. If you are married, your spouse may be able to receive all or part of your income under the Minimum Monthly Maintenance Needs Allowance.
The Minimum Monthly Maintenance Needs Allowance
The Minimum Monthly Maintenance Needs Allowance permits the institutionalized spouse to transfer income to the community spouse to meet a minimum threshold of monthly income. The community spouse is the spouse at home defined as the legal husband or wife of an institutionalized individual living in a noninstitutionalized living arrangement (e.g. at home). If both spouses are institutionalized, there is no community spouse and the Minimum Monthly Maintenance Needs Allowance is not available. The purpose of the Minimum Monthly Maintenance Needs Allowance is to provide income to the community spouse to maintain a standard of living above the poverty level. If the community spouse’s monthly income is less than $2,931 (2014), the institutionalized spouse may transfer income to the community spouse to reach this minimum amount of monthly income. Income sheltered under the Minimum Monthly Maintenance Needs Allowance does not count towards the income limit and reduces the amount of countable income for Medicaid eligibility purposes. In addition the Minimum Monthly Maintenance Needs Allowance provides an exception to the Patient Liability Amount. If the community spouse has insufficient income to meet the Minimum Monthly Maintenance Needs Allowance threshold, income from the institutionalized spouse is diverted to the community spouse rather than used to pay a portion of the cost of care as the Patient Liability Amount.
These are the basic income rules for Medicaid Long-Term Care benefits in Louisiana. The second test is the resource or asset test and will be discussed in the next blog post.
If you have questions about qualifying for Medicaid Long-Term Care benefits in Louisiana, contact lawyer John Sirois at 985-580-2520 or email him.
You can also find more information about Louisiana Medicaid in his recently revised book, Louisiana Retirement and Estate Planning, 2014 Edition available by contacting John or through Amazon.com. Additional information is available by visiting the Medicaid and Long-Term Care section