Breaking News: New York will apply new Medicaid budgeting rules for home care.

by David Goldfarb Goldfarb Abrandt Salzman & Kutzin LLP

Couples, where one person is receiving Medicaid home care through the Managed Long Term Care program will be able to use the “spousal impoverishment” budgeting rules or the old community based budgeting rules – whichever is more favorable. On Sept. 24, 2013, New York State Department of Health announced that “spousal impoverishment protections” are available to married participants in all Managed Long Term Care (MLTC) plans, including PACE and Medicaid Advantage Plus plans.  These rules were expanded to the Traumatic Brain Injury (TBI) and Nursing Home Transition and Diversion (NHTD) waiver programs last year and had previously been applied to the “Lombardi Program” (Long Term Home Health Care Program).

These “spousal impoverishment protections” have been used by couples where one spouse is in a nursing home since 1988. Under these rules income can be shifted from the spouse receiving Medicaid to the well spouse to bring his or her income up to a Minimum Monthly Maintenance Allowance ($2,931 in 2014). In community based programs the Medicaid spouse can keep a Personal needs allowance (in 2014 $383).

These rules are complex and there are advantages and disadvantages. Applicant/recipients and their spouses should consult an Elder Law attorney before making a decision on which budgeting method to use.

See more detailed article.


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