What is the Medicaid Look-Back Period?

Each fall, the Centers for Medicare & Medicaid Services (CMS) renews the federal guidelines that seek to protect individuals whose spouses are applying for or receiving Medicaid long-term care benefits.These protections, known as the Spousal Impoverishment Standards, help to support the financial well-being of seniors who continue residing at home while their spouse on Medicaid lives in a long-term care facility, such as a nursing home.Qualifying for Medicaid Long-Term Care BenefitsLong-term care is prohibitively expensive for many, so a large share of adults aged 65 and older rely on Medicaid to help cover the costs.To qualify for Medicaid long-term care benefits, however, one must generally have very limited resources. In most states, the asset limit is set at $2,000. (Certain assets, such as personal belongings and the applicants primary residence, do not count toward this limit.) The applicants income typically goes to the nursing home as well, with some exceptions.So, what happens if a person who qualifies for Medicaid long-term care is married? How can their healthy spouse afford to remain on their own at home? This is where the Spousal Impoverishment guidelines help.2024 Spousal Impoverishment FiguresCommunity Spouse Resource Allowance (CSRA)A spouse who continues living at home while their partner receives long-term care coverage through Medicaid can keep up to $154,140 in assets starting in 2024.The healthy spouse, or so-called community spouse then has a minimum amount of assets to live on without rendering their Medicaid spouse ineligible for benefits. This special protection is known as the Community Spouse Resource Allowance (CSRA). The maximum CSRA generally rises each year; in 2023, it was $148,630.Meanwhile, according to federal law, no state can set the minimum CSRA below $30,828 as of 2024.Monthly Maintenance Needs Allowance (MMNA)In addition to CSRA, the federal government offers another level of protection for the community spouse: the Monthly Maintenance Needs Allowance (MMNA).The MMNA ensures that the healthy spouse who continues to live in the couples home maintains a certain amount of monthly income while their partner receives their Medicaid long-term care coverage. (Learn more about the ins and outs of MMNA.)In 2024, the maximum MMNA will be $3,853.50 (up from $3,715.50 in 2023). Again, this is the most in monthly income that the community spouse can keep while their spouse lives in a long-term care institution. If the healthy spouse does not make enough income to live on, this allowance comes from the income of the spouse on Medicaid.Note that the minimum MMNA for 2024 can vary depending on your state. Alaska and Hawaii typically have slightly higher minimums. The federal government updates the minimum MMNA each July.A Note on Income Cap StatesCertain states have in place a Medicaid income cap. If you reside in one of these income cap states, you will not qualify for Medicaid if your income equals more than $2,829 (in 2024) unless you have a certain type of trust in place. This trust, known to many as a Miller Trust, must hold any income you receive that is above that cap.As of 2023, the 23 income cap states were Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Louisiana, Mississippi, Nevada, New Mexico, New Jersey, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming.Home Equity LimitsAs mentioned above, Medicaid does not consider the primary home of an applicant as a countable asset, unless the applicants equity interest in their home is above a certain amount.Your home equity equals your homes value minus the sum of any loans you owe on the home. In 2024, the home equity limit is set to $713,000. (Some states choose to raise this limit to $1,071,000.)Contact Entrusted Legacy Law at 412-347-1731 to schedule a complimentary 15-Minute call.

As your loved one ages, you may grapple with the challenging task of finding long-term care. It's a difficult and stressful time for all involved, and navigating the complexities of Medicaid benefits can add confusion and frustration to an already overwhelming situation.That's where a Florida Long Term Care Financing Solutions Company such as Platinum Benefit Services can help. With over 26 years of experience helping over 14,000 clients obtain Medicaid benefits, their team of professionals can help you understand and navigate the intricacies of Medicaid benefits for long-term care.Understanding the Differences in Medicaid Benefits:It's important to note that the Medicaid benefits for home health care or assisted living are different from the Medicaid benefits for a loved one in a skilled nursing facility. Medicaid will cover up to 40 hours of in-home care per week for the Medicaid recipient. If  the patient is either in an assisted living facility (ALF) or wishes to transition to one. Medicaid will pay part of the monthly assisted living bill, and the patient is responsible for paying the remainder.Not all ALFs are contracted with Medicaid, but for the ones that are, each Medicaid-contracted facility has a separate agreement for the amount that Medicaid will cover. This can make it difficult to understand exactly how much you'll be responsible for paying. A Florida long term care financing solutions company can help you navigate these complexities and understand exactly what you'll be responsible for paying.On the other hand, when a patient is in a skilled nursing facility (SNF), the patient must pay the facility all their monthly income minus a personal needs allowance (PNA) of $130, as well as being able to deduct any monthly premiums for health insurance from the patient's responsibility. Medicaid will pay the remainder of the bill owed to the SNF. Navigating Complex Scenarios:There are also more complex scenarios that a Florida long term care financing solutions company can help you with. For example, having a community spouse to which you can divert income can reduce or eliminate the amount you owe to the skilled nursing facility. These nuances can be difficult to understand and navigate, which is why it's so important to seek the help of a professional.Seek Help from a Florida Long-Term Care Financing Solutions Company:When you're already under immense stress and pressure to help your loved one that is needing care, the complexities of Medicaid benefits can be overwhelming. That's why it's important to seek the help of a Florida long term care financing solutions company such as Platinum Benefit Services. Their team of professionals can help you understand the nuances of Medicaid benefits, navigate complex scenarios, and make informed decisions about your loved one's long-term care.Conclusion:Platinum Benefit Services is a trusted Florida long term care financing solutions company with extensive experience helping clients obtain long-term care Medicaid benefits. If you or a loved one need assistance navigating the complexities of Medicaid, contact us for expert guidance and support.

Medicaid planning is a strategy that can safeguard the future of senior citizens. This is a complex process, and it needs thorough consideration of various factors to ensure maximum benefits. Here is a list of 6 essential factors to remember during Medicaid planning for senior citizens.Eligibility Criteria:One has to meet certain parameters to avail of the benefits of Medicaid. Therefore, it is important to understand this requirement before proceeding with Medicaid planning for senior citizens. The income limits can be varied by state. The asset limits also vary, and assets like cash, investments, and property are considered.Asset Protection:Protecting the assets while availing the Medicaid benefits is also an important consideration that the applicant has to consider. Experienced attorneys implement various strategies like altering countable assets to exempt assets to protect the applicant's interest. Sometimes, prepaid funeral plans and particular annuities can also be used to protect assets during Medicaid planning for senior citizens.Lookback Period:Medicaid has a certain "lookback period." During this time, if any assets get transferred, they will be reviewed. Though this lookback period varies by state, it typically lasts five years. If the asset transfer has occurred during this period for less than the market value, then Medicaid may penalize that individual. Planning accordingly and avoiding improper asset transfers during this period is crucial in such conditions.Income Planning:Applicants with more than the Medicaid income limit must establish Miller Trust to get Medicaid benefits. This trust helps to deposit the excess income and use the money for future medical expenses. However, before going ahead, it is crucial to understand the specific rule associated with creating and managing trust.Long-Term Care Planning:Medicaid covers long-term care services that seniors require. This service can be availed at a nursing home or in the home. While considering Medicaid service, it is important to consider which specific care the senior needs and whether they can align with the Medicaid coverage in that state.Estate Planning:Estate planning is part of Medicaid planning. It mainly focuses on meeting the senior's wishes while maximizing Medicaid benefits. This planning phase involves creating a will, establishing trusts, or drafting power of attorney. Estate planning helps to protect assets from unwanted heirs.Conclusion:Medicaid planning for senior citizens is complex, and many rules and regulations are involved. Understanding the eligibility criteria, and other aspects is crucial for maximum benefit. Therefore, hiring any senior citizen attorney to handle this process is recommended. We at Platinum Services can guide and assist you in your Medicaid planning.