Law Office of John L. Roberts
Elder Law Attorney Certified by the National Elder Law Foundation
1200 Converse Street, Longmeadow, Massahcusetts 01106


Protecting Independence and Preserving Assets

By Attorney John L. Roberts

The tiny Personal Needs Allowance (PNA) that nursing home residents are allowed to keep will remain at $72.80 per month, under a budget proposed by the Ways and Means Committee of the Massachusetts State Senate on May 19, 2010. The Personal Needs Allowance is one small component of the state's $2.49 billion Senior Care budget, which will increase slightly from $2.33 billion spent during fiscal year 2010.

Last year the Legislature had passed a supplemental budget which set a lower PNA: only $69.68 per month. But the $72.80 amount is now restored in a budget passed by the House of Representatives and the Senate Ways & Means committee. This small monthly allowance for personal needs of a nursing home resident emphasizes the importance of Medicaid planning.

It is never too late to take steps to protect your life savings from Medicaid liens or to set aside funds for a loved one who must be admitted to a nursing home. When you are caring for a loved one who may need nursing home care, your time is precious. Your time and attention is devoted to making sure your family member is receiving the care that protects their health and well being. Time is also valuable when you consider the daily cost of a nursing home. Every month of lost eligibility costs more than $7,000.

When you hire us for Medicaid planning, we will:

MassHealthFor one flat fee, we provide you with the advice and services you need to get long term care benefits.

Asset transfers are now scrutinized going back five years from the date you file an application for Medicaid benefits. In other words, asset transfers must be listed on the Medicaid application, unless 5 years have passed since the date of the transfer:

If an asset is transferred within the 5 year period, there is a disqualification period based on the value of the asset. The penalty period begins on the month the transfer was made, OR
the date on which the elder is eligible for Medicaid, and would otherwise be receiving nursing home care paid by Medicaid, if he or she had not transferred the asset.

If an asset is transferred today . . .

the asset transfer must be reported on a Medicaid application that is filed within the next 5 years . . .

Until 5 years from today in:
2010
2011
2012
2013
2014
2015

The sooner you start planning, the more options and choices you have.
Click here for: Calculator that finds the eligibility date five years after an asset is transferred.

Important Information for Married Couples:
If the person who applies for MassHealth nursing home benefits is married, that person's spouse is known as the "community spouse" because that spouse continues to live in the community. The community spouse is allowed to keep an amount of assets Community Spouse Resrouce Alowance CSRAcalled the Community Spouse Resource Allowance. Under Massachusetts Medicaid law [Chapter 118E, Section 21A (a)(1)(v)] the state legislature requires that our MassHealth agency “shall establish the maximum community spouse resource allowance permissible under 42 U.S.C. s.1396r-5(f)(2).” That maximum amount is set by the Centers for Medicare and Medicaid Services.. The maximum amount for 2010 is $109,560. Link to CMS Medicaid eligibility information. This maximum amount is unchanged since January 1, 2009. CMS Fact Sheet Showing 0% COLA for 2010. The maximum amount for 2008 was $104,400

The CSRA allows elderly spouses, usually women and widows, to maintain a measure of financial security. It will help elderly spouses avoid the indignities of impoverishment, and can prevent the need for premature nursing home placements. If you have a spouse, mother, father, uncle, aunt, or other relative who receives nursing home care now, or may need care, we can help your family plan for the future.

For 2010, there are no increases in the income or asset amounts allowed to the community spouse:

Income: If the nursing home resident is married to a spouse who lives at home, the healthy spouse needs income to live. The spouse who lives at home is allowed to keep some, or all of the income that is paid in the name of the spouse who is in the nursing home. This is called the Minimum Monthly Maintenance Needs Allowance ("Minimum MMNA"). On July 1, 2009 the MMNA was increased to $1,821.25, and remains at that amount until July 1, 2010. CMS Spousal Impoverishment and Eligibility Figures. (As of July 1, 2007 this figure was $1,711.25. As of July 8, 2008: $1,750 per month).

The Minimum MMNA is the minimum amount of income needed for living expenses by the spouse who is still healthy enough to live in the community. If her/his income falls below this amount, the healthy spouse is able to keep income or assets of the institutionalized spouse.

The spouse who needs nursing home care is only allowed to keep income of $72.80 per month as a personal needs allowance.

Housing expenses for the spouse at home that are more than a standard amount can be added to increase the Minimum MMNA. If you are entitled to an increased amount, I can help you and your family to obtain the increased amount. Federal Medicaid Law [Section 1396a(a)(3)] gives us the right to a fair hearing for "any individual whose claim for medical assistance under the plan is denied or is not acted upon with reasonable promptness." Federal Regulations [42 CFR 431.230] require that Medicaid payment for services be continued during the time an application is waiting for a fair hearing, and the state must make corrective payments if the applicant wins the fair hearing.

The Maximum Monthly Maintenance Needs Allowance. The Maximum MMNA is $2,739.00 during 2010, unchanged since January 1, 2009 (previously as of January 1, 2008: $2,610). This is the upper limit on a nursing home resident's income and/or assets that are allowed to his/her spouse, unless the healthy spouse shows exceptional circumstances. I can help you and your family if a hearing or court decision is needed to explain exceptional circumstances and obtain a higher amount.

The Standard Shelter Expense is the amount included in the Minimum MMNA for rent, mortgage payment, property taxes and insurance, and/or condo maintenance charges. If these housing expenses are greater than an amount set by MassHealth, the extra expenses can be credited to the community spouse's Minimum MMNA.

Excess Shelter Allowance
$514
Utilities (CS pays for heat) $528
Utilities where heat is included in monthly rent $320

Additional amounts can be credited for heat and utilities. Housing expenses that are more than the standard amounts can be added to increase the MMNA. Call 567-5600 for an appointment to learn how Medicaid can help you and your family manage the costs of long term care.