Page 29 - Senior Link Magazine Spring 2025 - Online Magazine

SENIOR RESOURCES SENIOR RESOURCES

2025 UPDATE FOR

Medicaid's Nursing Home

Assistance Program by Lee Franks

Regarding the topic of this article, I do not advise the reader to take any particular action without consulting a competent attorney first. Do
not take it personally, but I do not represent you until we have met, and I have agreed to represent you. For the purposes of this article, the term
‘Medicaid’ refers generally to Medicaid for the Elderly and People with Disabilities, or MEPD, and specifically to nursing home care assistance.

ost people cannot afford the nursing home bill, effectively a the community spouse to make up
a lengthy stay in a co-pay. the difference.
Mnursing home, but for the
relatively small percentage of the The $2,000 individual asset limit, Although, it may not look like it
population who need it, Medicaid is called by Medicaid “the countable from such a brief summary, it is
the only available public assistance. resource limit,” generally causes possible to obtain assistance to
Medicaid is a needs-based, means- the biggest problems. Medicaid pay for nursing home care and still
tested federal program administered exempts a person’s residence equity preserve some wealth, especially
by the states. In Texas, that job falls (up to $730,000) and one car of for those who are married to a
to the Texas Health and Human any value, and it also exempts spouse in the community. Those
Services Commission. Aside from retirement funds, for example who find themselves or a loved one
having to be over 65 or disabled, IRAs, 401(k)s, and 403(b)s, under requiring nursing home care should
the person applying for Medicaid the right conditions. Aside from consult with an attorney familiar
assistance must have a medical personal property, a pre-need with Medicaid to find out what
necessity to which only a licensed funeral contract, and a few other assistance is available to them.
medical professional can attend and rare exceptions, Medicaid counts
reside in a skilled nursing facility. everything else (beware
In addition, Medicaid imposes the cash value of life
income and asset limits. insurance).
The income limit changes If the person is married,
every time the Social Security and that spouse does not
Administration makes a cost-of- live in a nursing home,
living adjustment or COLA. This then Medicaid provides
year, the new individual income for a Spousal Protected
limit is $2,901 (gross) per month. Resource Amount
As it happens, income rarely affects (the SPRA) which
eligibility since Medicaid provides ranges from $31,584 to
a work-around in the form of a $157,920. Interestingly,
Qualified Income Trust, also known Medicaid does not
as a Miller Trust. Note well that require the community
the Miller Trust works ONLY for spouse to contribute any
income; it does NOT shield assets of his or her income to
from Medicaid. The person can the nursing home bill. In
keep $75 per month, the Personal fact, if the community
Needs Allowance (the PNA), and spouse’s monthly gross
enough to pay monthly health income is less than
insurance premiums, otherwise all $3,948, the person can
the person’s income is applied to divert enough income to