Medicaid Income Rules

The rules governing income of Medicaid ICP applicants are more complex than the asset requirements.  However, similarly to the asset rules, the income rules can be divided into the two most common scenarios: a married applicant and a single applicant. 

Single Applicant

For 2009, a single Medicaid ICP applicant in Florida can have $2,022 in monthly income and still qualify for benefits.  What happens if the applicant has more than that in income, is the applicant denied Medicaid ICP coverage?  No.  It simply means that an additional planning tool must be used to qualify the applicant.  Any income over the $2,022 must be deposited into a special trust account called a "Qualified Income Trust", or "Miller Trust".

An example will help:

Joe is single and needing nursing home care.  His daughter, who is Joe's agent under a Durable Power of Attorney, has come to my office hoping to get Joe qualified for Medicaid ICP after being told by a hospital social worker that he had too much income.  Currently he receives the following:

• $1,250 in gross Social Security benefits;

• $750 in a retirement pension; and

• $300 from an annuity.

Total income for Joe is $2,300, or $278  over the allowed amount.  Accordingly, Joe must place at least the excess $278 into the Qualified Income Trust each month.  His daughter or our office can assist him with this process. All of Joe's income, less $35 each month, will go to pay his nursing home bill.

Married Applicant

A married applicant is also limited to the $2,022 income limit per month.  Any excess will need to be deposited into a Qualified Income Trust, just as Joe did in the example above.  However, in this situation, there is a spouse at home whose financial needs must be met as well.  The non-applicant spouse is entitled to a minimum amount of the nursing home spouse's income.  That amount is called the Minimum Monthly Maintenance Allowance (MMMA).

The Minimum Monthly Maintenance Allowance (MMMA) for the non-applicant spouse is $1,822. An example will help:

John is married to Susan.  John is in need of nursing home care.  As is common for the Greatest Generation, John was the breadwinner and currently receives the majority of the income from Social Security and a pension.  John's income is as follows:

• $1,250 in gross Social Security benefits;

• $750 in a retirement pension; and

• $300 from an annuity.

This is a total of $2,300 per month.  However, Susan only receives $600 in Social Security benefits.  As such, she is entitled to at least $1,222 of John's income to bring her up to the MMMA ($600 + $1,222 = $1,822).  Please note that $1,822 is the minimum amount that Susan would receive.  A community spouse's particular situation may result him/her receiving up to $2,739.  Call today for more details!