Tag Archives: Unique Medicaid rules

Nursing Home Expenses

Use of Medicaid Recipient’s  Income to Pay Existing Nursing Home Expenses

The Department of Health and Mental Hygiene released a critical Medical Assistance eligibility update (MR 154).   The changes in this update are profound.  It now allows a nursing home Medical Assistance recipient to use her income to pay for nursing home related expenses (up to 3 months retroactive) to the extent Medical Assistance does not cover said expenses (i.e. she has resources in excess of $2,500).  This is a profound change by the Department and took many years of litigation by another respected elder law attorney to finally achieve this result.  Bottom line, however, is that this can be a benefit for many families that are faced with outstanding nursing home expenses with no normal Medical Assistance coverage for said expenses.

The issue is this, your mother has outstanding nursing home bills and when the application was made for Medical Assistance, she did not have enough assets to pay these invoices.  Given the size of nursing home costs, the outstanding expenses could well be thousands, even tens of thousands of dollars.  The nursing home is going to look for payment of these invoices and may well start the involuntary discharge process unless they are paid.  This new Medical Assistance provision allows for mom’s income to be used to offset these expenses for the three months prior to eligibility.  Since this is a brand new provision, it is unclear at present at how efficiently such a request will be implemented by the Department of Social Services.  If you find yourself in this position, it is best to contact an elder law attorney to guide you through this process.

Update:  The Department of Health and Mental Hygiene will likley apply the allowance for three months prior to the application date which will overlap the current retroactive Medical Assistance eligibility period.   However, there will be some instances where retroactive Medical Assistance eligilbity may not be available and where this new provision may be of profound help to many individuals.

Medicaid Asset Threshold

Asset Levels for Maryland Medicaid

For Maryland purposes, the Medicaid applicant can have no more than $2,500 in countable assets while the community spouse can have no more than $126,420 (can be less) in countable assets.  There are many instances where the community spouse will have a lower asset threshold.  The key is what is a “countable asset.”