Medicaid Income Rules for Healthy Spouses

Before we dive into the Medicaid Monthly Maintenance Needs Allowance, we should provide some general background information about long-term care costs. Most people will qualify for Medicare when they reach the age of eligibility, which is currently 65.

This will provide a relatively solid health insurance underpinning, but there are out-of-pocket expenses. These include copayments, deductibles, and monthly premiums. In fact, the program only pays 80% of bills that you receive from doctors, and you have to pay the rest.

In addition to these personal responsibilities, there is an enormous void in the coverage that impacts a very significant percentage of senior citizens. Long-term care in a nursing home or assisted living facility is considered custodial care, and Medicare does not cover this form of assistance.

It is hard to pay these expenses out-of-pocket without seriously impacting your legacy because long-term care costs are through the roof. The exact cost will depend upon the facility, but median charges for a private room are approaching $100,000 in the Charlotte area, and costs have been rising.

About 35% of seniors will reside in nursing homes eventually so this is not something that you can safely ignore. And of course, other forms of living assistance are also very expensive.

Medicaid Coverage

Medicaid is another health insurance program that is administered by the federal government along with each state government, and it will pay for custodial care. In fact, most people in nursing homes are enrolled in this program, and many of them were not financially needy prior to needing nursing home care.

The limit on countable assets for an individual is just $2000 since Medicaid is a need-based program. There are some assets that do not count, but we will discuss those in another blog post.

When a married person applies for Medicaid to pay for long-term care and their spouse is capable of living independently, the healthy spouse is entitled to certain allowances. One of them is the Medicaid Monthly Maintenance Needs Allowance.

This gives the healthy spouse the ability to continue to receive income that was brought in by the spouse who needs care if the income is needed to maintain a certain minimum standard of living. In North Carolina in 2019, the maximum monthly maintenance needs allowance is $3160.50. The minimum is $2057.50.

So let’s say that a healthy spouse was earning $700 on their own, and the spouse in a long-term care facility was bringing in $1400 a month. The state has mandated a minimum allowance of $2057.50. Under these circumstances, the healthy spouse would be able to receive $1357.50 on a monthly basis from the income of the spouse who was in a nursing home.

Attend a Free Seminar!

We have looked at one small aspect of the Medicaid program as it applies to nursing home asset protection strategies here. If you would like to learn more about the subject, we are offering some tremendous opportunities in the near future.

Our attorneys conduct seminars that take a close look at nursing home asset protection, and you can learn a great deal if you attend one of these sessions. There is no charge, so you have nothing to be concerned about on that level, but we ask that you reserve your seat in advance.

You can check out the dates if you visit our seminar page, and after you identify the one that works for you, click on it and follow the simple instructions to register.