Numerous myths and misconceptions continue to circulate about Medicaid for seniors. One of those caused many seniors who could benefit from qualifying for Medicaid to shy away from applying. That myth causes people to worry that a spouse will be left destitute if you need to qualify for Medicaid. To help clarify, the Medicaid planning attorneys at Legacy Care Law Firm explain the spousal impoverishment rules for New Hampshire Medicaid for seniors.
Why Might You Need to Qualify for Medicaid?
Experts estimate that for someone turning 65 today, there is a 70 percent chance that they will need some type of long-term care services before the end of their life. That means that if you are married, the odds are more than favorable that one of you will need long-term care (LTC) at some point. If you are a New Hampshire resident, the cost of that care will be particularly high. In fact, the national average for a year of nursing home care for 2022 was just over $100,000. For a New Hampshire resident, however, that same year of care averaged just over $144,000. You can expect to pay, on average, about half of that cost for a year of assisted living or a home health aide.
What makes the high cost of LTC even more problematic for the average person is that Medicare will not pay for it. As a retiree, you may depend on Medicare to cover most of your healthcare expenses, only to realize that the program will not pay for one of the most expenses healthcare costs you are likely to encounter during your retirement years. If you retained private health insurance coverage, it is unlikely that your policy will cover LTC unless you purchased a separate long-term care insurance policy. So where does that leave seniors in need of long-term care services? For more than half of them, Medicaid is the only option. Medicaid, however, employs income and asset limits when determining eligibility for benefits.
Medicaid Income and Asset Limits
When reviewing an applicant for Medicaid, the program uses income and asset limits. For 2023, the income limit for an individual applicant is $2,742 and double that for a married couple applying together. The countable resources, or asset, limit is just $2,000 for an individual; however, different rules apply when one spouse needs nursing home care, and the other spouse plans to remain in the community (known as the “community spouse”).
What Is the Medicaid Income and Resource Standard?
Certain Medicaid income and resource standards are adjusted beginning each January in accordance with changes in the SSI federal benefit rate (FBR) and the Consumer Price Index (CPI). Many states offer, for example, categorical eligibility to individuals who are not receiving SSI but who meet the financial eligibility requirements of the program, as authorized by 1902(a)(10)(A)(ii)(I) of the Social Security Act (“the Act”). Similarly, most states have adopted the “special income level” institutional eligibility category authorized under Section 1902(a)(10)(A)(ii)(V) of the Act, the maximum income standard for which is 300% of the SSI FBR. Additionally, certain eligibility standards relating to coverage of long-term services and supports, including the home equity limitation in Section 1917(f) of the Act and elements of the spousal impoverishment statute in Section 1924, are increased each year based on increases in the CPI for All Urban Consumers (CPI-U).
In short, Medicaid adjusts all eligibility standards, including the spousal impoverishment standard, each year. To know why these standards matter, you need to understand what the spousal impoverishment rules are and how they impact you and your spouse.
Medicaid Spousal Impoverishment Standards
There was a time when a couple had to “spend-down” all their assets for one of the spouses to be eligible for Medicaid to cover nursing home care. This left the “community spouse” without any assets. The Medicaid spousal impoverishment rules were implemented a long time ago to prevent this from happening going forward. Today, both the Community Spouse Resource Allowance and the maximum monthly maintenance needs allowance protect the community spouse when a spouse needs help from Medicaid.
The “Community Spouse Resource Allowance (CSRA)” allows the community spouse to retain 50 percent of the couple’s assets, up to a maximum of $148,620, as of 2023. If the non-applicant’s share of the assets falls under $29,724, 100% of the assets, up to $29,724 can be retained by the non-applicant.
In New Hampshire, the maximum monthly maintenance needs allowance (MMMNA) is $2,465 through June of 2024. If a non-applicant’s monthly income falls under $2,289, income can be transferred to them from their applicant spouse, bringing their income up to this level. A non-applicant spouse can further increase their Spousal Income Allowance if their housing and utility costs exceed a “shelter standard” of $739.50 / month up to a maximum Spousal Income Allowance of $3,716. This is the Maximum Monthly Maintenance Needs Allowance.
Contact Our Medicaid Planning Attorneys
For more information, please join us for an upcoming FREE seminar. If you have additional questions about the Medicaid spousal impoverishment rules in New Hampshire, contact our Medicaid planning attorneys in our North Andover, Woburn, and Beverly offices at (978) 969-0331. Our Salem and Nashua, New Hampshire office can be reached at (603) 894-4141.
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