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Where does my income go when I am on nursing home Medicaid?

Income rules for long-term care Medicaid have a number of moving parts that vary based upon marital status.

A single person on Medicaid in the nursing home must pay their countable income to the facility as part of his "patient's responsibility." In effect, the Medicaid applicant must pay their income to the facility as part of their co-pay, where Medicaid pays the rest of the funds for the resident's stay. The single applicant is allowed to keep $105/month as part of his "personal needs allowance." This allows the resident to buy personal items such as clothing and toiletries. 

A married person in the nursing home has the same set of rules with one large qualification - the spouse at home may be able to keep some of the applicant's income as part of the community spouse's income allowance (CSIA). The community spouse may be able to siphon off some of the applicant's income based upon the community spouse's own income. An example of this is as follows:

Married nursing home resident with $2,000/month income applies for Medicaid. The spouse at home (the community spouse) only has income of $1,000/month.  The spouse at home, as a minimum, may keep $1,030/month of the resident's income, at a minimum. This amount varies annually. This means that the nursing home resident can keep $105/m as their personal needs allowance, paying $865/m to the nursing home as their patient's responsibility.  ($2,000 minus $1030 minus $105 = $865)

If the applicant's income exceeds $2205/month, they will need a Qualifed Income Trust (QIT). The QIT generally does not effect where the income goes (i.e., to the nursing home/community spouse) but how it gets there.

If your loved one is looking at long-term care or Medicaid in Florida, you are welcome to attend one of our free monthly seminars to learn more!

D. Rep DeLoach III
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