There have been changes to two key numbers Florida uses when assessing an applicant’s eligibility for Medicaid nursing home benefits. These changes went into effect July 1, 2022.
Minimum Monthly Maintenance Needs Allowance
The income of an applicant’s spouse is not considered when assessing the applicant’s eligibility for Florida Medicaid long-term nursing care benefits. However, if the “community” (well) spouse’s income falls below the Minimum Monthly Maintenance Needs Allowance, a portion of the applicant’s income may be diverted to the well spouse in order to bring the well spouse’s income up to that level.
Effective July 1, 2022, the Minimum Monthly Maintenance Needs Allowance increased to $2,289 (was $2,178).
Example of how the MMMNA applies to Medicaid benefits: Medicaid applicant John Doe is residing in a long-term care nursing home. He applies for Florida long-term care Medicaid benefits. His gross monthly income is $4,000. His wife Mary Doe has only one source of personal income: $1,000 in monthly Social Security, which is $1,289 below the current MMNA of $2,289. Medicaid will allow $1,289 of John Doe’s income to be diverted to Mary Doe in order to raise her income to the MMNA. Under certain circumstances, even more may be diverted to raise the level over the MMNA. The Karp Law Firm attorneys will advise you about the MMMNA.
The penalty divisor is used to calculate the length of any penalty period that will be imposed if the applicant has made transfers for less than fair market value during the five-year period preceding application. (The divisor is effectively an estimate of the monthly cost of nursing home care in the state.)
Effective July 1, 2022 the divisor increased to $10,809 (was $9,703).
Example of how penalty divisor applies to Medicaid benefits: John Doe has had a debilitating stroke and now needs the care of a long-term care facility. He applies for long-term care Medicaid benefits on September 1, 2022. When he applies, Medicaid looks back at the five-year period preceding application. Medicaid sees that in 2019, he gave $30,000 to his daughter; and in 2020, he gave $20,000 to his son, for a total of $50,000. Medicaid divides $50,000 by the penalty divisor, $10,809, which yields 4.63. Mr. Doe must wait 5 months (Medicaid always rounds up the figure) to begin receiving benefits. His benefits will commence February 2023. Until then, he will have to pay the nursing home out of his own pocket. However, our attorneys can show you legitimate methods to avoid or minimize the penalty period.
To see a complete list of Medicaid eligibility requirements, click here.
To read about planning in advance with a Medicaid Asset Protection Trust, click here.