Friday, July 27, 2012

Medical Assistance Numbers for Long Term Care Eligibility published


The Pennsylvania Department of Public Welfare has updated its Medical Assistance (Medicaid) Fact Sheet for MA LTC/HCBS Eligibility. The Fact Sheet provides the current figures used in determining an applicants eligibility for Medicaid benefits for long term care services and home and community based services in Pennsylvania as of July 1, 2012. 

The qualification rules for these Medicaid programs are extremely complicated. Persons who are interested in applying for Medicaid LTC or HCBS should consider consulting with an experienced elder law attorney to assist in the planning and process. 

Here are the figures from the current Fact Sheet:

MA LTC/HCBS Eligibility
Fact Sheet (eff 7/1/2012)
Step 1: Determining LTC/HCBS MA Eligibility

NMP
MNO (LTC only)
INCOME
$2094 mnt. (Gross)
$2,550 6 mnths (Net)
 Less:   - $20/mnth disregard
-        Medical expenses
-        Health Ins Premiums
-        6 mnth anticipated cost of LTC Facility (avg mnthly Private Pay Rate)



RESOURCES
$2000*
*Effective 10/31/03 there is an additional $6000 resource disregard for NMP (300% FBR) categories of LTC NMP
$2400



SPOUSAL IMPOVERISHMENT - COMMUNITY SPOUSE SHARE
Min: $22,728
Max: $113,640

EXCESS HOME EQUITY LIMIT
$525,000




AVG MONTHLY PRIVATE PAY RATE
$8,112.13

AVG DAILY PRIVATE PAY RATE
$266.70









STEP 2: DETERMINING Payment Towards Cost of Care (Patient Pay Liability)
PERSONAL NEEDS ALLOWANCE
$45/mnth
MAINTENANCE NEEDS ALLOWANCE
Min: $1892/mnth
Max: $2841/mnth
DEPENDENT LIVING WITH CS ALLOWANCE
$1892


EXCESS SHELTER STANDARD
$568
SHELTER COSTS
·        Heating Standard
·        Non-Heating Standard
·        Homeless Standard
·        Limited SUA
·        Phone Only

$536
$278
$143
$53
$33
HOME MAINTENANCE DEDUCTION
$720.10/mnth (6 mnth limit)
MEDICARE PART B PREMIUM
$99.90/ or various



SSI/ STATE SUPPLAMENTS

Personal Needs Allowance
Elig Person
Elig Couple
LTC Facility
$45/mnth
SSI
SSP
SSI
SSP
Indep Living

$698.00
$22.10
$1048.00
$33.30
Someone’s HH

$449.34

$674.30

Pers Care Home
$85/mnth
$698.00
$439.30
$1048.00
$957.40
Dom Care Home
$178.30/mnth
$698.00
$434.30
$1048.00
$947.40

1 comment:

Miller Moore said...
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