Nursing Home Medicaid for Married Couples—Allowable Expenditures

We have mentioned that many nursing home residents pay their whole income, minus $50, to the nursing home leaving Medicaid to pay the remainder of the nursing home bill. In addition to the $50 personal needs allowance, Georgia allows its nursing home residents who are receiving Medicaid benefits to also pay certain bills out of their income. This reduces the amount of the nursing home bill that a Medicaid resident pays and increases how much Medicaid pays the nursing home. These limited allowable expenditures include health insurance premiums, incurred medical expenses and a spousal diversion. For example, a nursing home resident who receives $3,300/month in income will be able to keep $50 for himself, pay his $379 MediGap Premium and divert $1,200 to his spouse (who has a monthly income of $1,822.50, or $1,200 below the Monthly Maintenance Allowance of $3,022.50). This leaves $1,671 that the resident must pay to the nursing home, and Medicaid will pay the difference. It is worth noting that in this case, a QIT (or Qualified Income Trust) will have to be used. As we talked about last week in our blog, any nursing home resident that makes more than $2,205/month in income, must use a QIT to be eligible for Medicaid. The Medicaid rules are complex, especially as they pertain to married couples. If you have questions or need more information, please contact us at (404) 843-0121.

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