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How to help elderly parents with Their Finances

5/29/2015

Regardless of whether your aging parents have shown any signs of mental decline, you need to talk with them about their finances before it's too late. If you don't know what they've done with their money, you won't be able to help them manage their affairs when it comes time.

Just like all matters that cause seniors to lose their independence, this one needs to be handled tactfully and delicately.

Having the "talk" with your elderly parent(s) seems about as awkward as the one they had with you before your teen years about sex. Everyone feels the embarrassment.

But, the earlier you initiate the conversation about your parent's investments, the better.

"It's helpful to know about money matters in case you need to harvest resources for your loved one's care.

Setting the stage
Consider where the discussion will take place. It should be a place where the senior parents feel comfortable. Find a location that signifies comfort and peace and will put them in the right mood -- their home, a park, a special restaurant or at the senior parent's attorney's office. Try not to make them feel ambushed though.

It may help to find someone the elder trusts and respects to witness the conversation. Try to uncover everything you can about your parent's investments during this time.

Ask the following questions:

What investments do you have?
Where are those investments held?
Who are the contacts for the investments?
How are the investments titled (joint accounts, individual, etc.)?
Is there a financial adviser in the picture?
What bank do you have your checking and savings accounts held
What income do you have and where are they from

"Ask your elder about IRAs (individual retirement accounts), credit union accounts, bank accounts and insurance policies.

Assessing the situation
Speaking with your parents about financial matters while they are mentally sharp and physically healthy is ideal, but sometimes mental decline makes it necessary for you to jump in quickly and either help or take over.

Financial capacity -- the ability to manage one's financial affairs in the aging population has been studied extensively In a report for the American Society on Aging, it was reported that older adults are most vulnerable to impairment and loss of financial skills and capacity as a result of not only Alzheimer's disease and related dementias, but also through normal cognitive aging.

By the time a parent has memory loss, they've already suffered damage to their financial decision-making.
If they frequently forget that they just talked with you, or they keep retelling the same stories, those are early warning signs something is wrong. The study also revealed these warning signs of seniors struggling with financial transactions:

Taking longer to complete everyday financial tasks.
Showing reduced visual attention to key details in financial documents.
Showing decline in arithmetic skills related to finances.
Showing decreased understanding of financial documents.
Having difficulty identifying risks in an investment opportunity.

The mail can be one of your best friends, it tells you when bills haven't been attended to and also gives you clues about the parent's investments. Normally, statements for taxes, trading and banking come in the mail. Look at those to get an idea of the condition of the senior's finances.

In addition to the mail, tax returns can also be a forensic tool. Look at returns from the past few years to see if they show interest or dividend income, indicating investments your loved one might have forgotten about.

Assisting your elder
Even though your parent might forget the details of his or her investments, you must make a point to never treat them as a child.

They accumulated this wealth and successfully got to this point in their lives, for now, you should assist and not take over. The takeover will occur when it should.

This can be a good time to get your own financial house in order. Make sure to discuss your investments with your own children. If you relay to them what you care about, why you donate to charity and what you believe about money alongside information about where you've put your money and why, you'll have strengthened their ability to handle your finances when the time comes.

Be sure to read our follow-up post next week when we talk about Powers of Attorney and Health Care Directives. These are important document s to have in place in the event a parent becomes incapacitated and you need to help.

Questions? Email us at [email protected]

Thank You

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Facts About Autism Spectrum Disorder [ASD]

5/28/2015

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Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

Signs and Symptoms:
People with ASD often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.

Children or adults with ASD might:

not point at objects to show interest (for example, not point at an airplane flying over)

not look at objects when another person points at them

have trouble relating to others or not have an interest in other people at all

avoid eye contact and want to be alone

have trouble understanding other people’s feelings or talking about their own feelings

prefer not to be held or cuddled, or might cuddle only when they want to

appear to be unaware when people talk to them, but respond to other sounds

be very interested in people, but not know how to talk, play, or relate to them

repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language

have trouble expressing their needs using typical words or motions

not play “pretend” games (for example, not pretend to “feed” a doll)

repeat actions over and over again

have trouble adapting when a routine changes

have unusual reactions to the way things smell, taste, look, feel, or sound

lose skills they once had (for example, stop saying words they were using)

Diagnosis:
Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis.

ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.

Treatment:
There is currently no cure for ASD. However, research shows that early intervention treatment services can improve a child’s development. Early intervention services help children from birth to 3 years old (36 months) learn important skills. Services can include therapy to help the child talk, walk, and interact with others. Therefore, it is important to talk to your child’s doctor as soon as possible if you think your child has ASD or other developmental problem.

Even if your child has not been diagnosed with an ASD, he or she may be eligible for early intervention treatment services. The Individuals with Disabilities Education Act (IDEA) says that children under the age of 3 years (36 months) who are at risk of having developmental delays may be eligible for services. These services are provided through an early intervention system in your state. Through this system, you can ask for an evaluation.

In addition, treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis.

Causes and Risk Factors:
All of the causes of ASD are not yet known, there are likely many causes for multiple types of ASD. There may be many different factors that make a child more likely to have an ASD, including environmental, biologic and genetic factors.

Many scientists agree that genes are one of the risk factors that can make a person more likely to develop ASD.
Children who have a sibling with ASD are at a higher risk of also having ASD.
ASD tends to occur more often in people who have certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis.
When taken during pregnancy, the prescription drugs valproic acid and thalidomide have been linked with a higher risk of ASD.
There is some evidence that the critical period for developing ASD occurs before, during, and immediately after birth.
Children born to older parents are at greater risk for having ASD.

ASD continues to be an important public health concern. Understanding the factors that make a person more likely to develop ASD will help everyone learn more about the causes. The CDC is currently working on one of the largest U.S. studies to date, called Study to Explore Early Development (SEED). SEED is looking at many possible risk factors for ASD, including genetic, environmental, pregnancy, and behavioral factors.

Who is Affected:
ASD occurs in all racial, ethnic, and socioeconomic groups, but is almost five times more common among boys than among girls. CDC estimates that about 1 in 68 children has been identified with autism spectrum disorder (ASD).

More people than ever before are being diagnosed with ASD. It is unclear exactly how much of this increase is due to a broader definition of ASD and better efforts in diagnosis. However, a true increase in the number of people with an ASD cannot be ruled out. We believe the increase in ASD diagnosis is likely due to a combination of these factors.

If You’re Concerned:
If you think your child might have ASD or you think there could be a problem with the way your child plays, learns, speaks, or acts, contact your child’s doctor, and share your concerns.

If you or the doctor is still concerned, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child. Specialists who can do a more in-depth evaluation and make a diagnosis include:

Developmental Pediatricians (doctors who have special training in child development and children with special needs)
Child Neurologists (doctors who work on the brain, spine, and nerves)
Child Psychologists or Psychiatrists (doctors who know about the human mind)

At the same time, call your state’s public early childhood system to request a free evaluation to find out if your child qualifies for intervention services. This is sometimes called a Child Find evaluation. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child’s age:

If your child is not yet 3 years old, contact your local early intervention system.
You can find the right contact information for your state by calling the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001. Or visit the ECTA website.
If your child is 3 years old or older, contact your local public school system.
Even if your child is not yet old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.
If you’re not sure who to contact, call the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001. Or visit the ECTA website.

Research shows that early intervention services can greatly improve a child’s development. In order to make sure your child reaches his or her full potential, it is very important to get help for an ASD as soon as possible.

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ABLE Act overview, for people with Disabilities

5/28/2015

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ABLE Act Overview

The Achieving a Better Life Experience (ABLE) Act of 2013 (S. 313/H.R.647) was introduced in the 113th Congress by a bipartisan, bicameral set of Congressional Champions including Sens. Robert Casey, Jr., (D-PA) and Richard Burr (R-NC), and Reps. Ander Crenshaw (R-FL), Chris Van Hollen (D-MD), Cathy McMorris Rodgers (R-WA), and Pete Sessions (R-TX).

The ABLE Act would amend Section 529 of the Internal Revenue Service Code of 1986 to create tax-free savings accounts for individuals with disabilities. The bill aims to ease financial strains faced by individuals with disabilities by making tax-free savings accounts available to cover qualified expenses such as education, housing, and transportation. The bill would supplement, but not supplant, benefits provided through private insurances, the Medicaid program, the supplemental security income program, the beneficiary’s employment, and other sources.

An ABLE account could fund a variety of essential expenses for individuals, including medical and dental care, education, community based supports, employment training, assistive technology, housing, and transportation. The ABLE Act provides individuals with disabilities the same types of flexible savings tools that all other Americans have through college savings accounts, health savings accounts, and individual retirement accounts. The legislation also contains Medicaid fraud protection against abuse and a Medicaid pay-back provision when the beneficiary passes away. It will eliminate barriers to work and saving by preventing dollars saved through ABLE accounts from counting against an individual’s eligibility for any federal benefits program.

ABLE Accounts: 10 Things You Must Know:

1. What is an ABLE account?

ABLE Accounts, which are tax-advantaged savings accounts for individuals with disabilities and their families, will be created as a result of the passage of the ABLE Act of 2014. Income earned by the accounts would not be taxed. Contributions to the account made by any person (the account beneficiary, family and friends) would not be tax deductible.

2. Why the need for ABLE accounts?

Millions of individuals with disabilities and their families depend on a wide variety of public benefits for income, health care and food and housing assistance. Eligibility for these public benefits (SSI, SNAP, Medicaid) require meeting a means or resource test that limits eligibility to individuals to report more than $2,000 in cash savings, retirement funds and other items of significant value. To remain eligible for these public benefits, an individual must remain poor. For the first time in public policy, the ABLE Act recognizes the extra and significant costs of living with a disability. These include costs, related to raising a child with significant disabilities or a working age adult with disabilities, for accessible housing and transportation, personal assistance services, assistive technology and health care not covered by insurance, Medicaid or Medicare.

For the first time, eligible individuals and families will be allowed to establish ABLE savings accounts that will not affect their eligibility for SSI, Medicaid and other public benefits. The legislation explains further that an ABLE account will, with private savings, "secure funding for disability-related expenses on behalf of designated beneficiaries with disabilities that will supplement, but not supplant, benefits provided through private insurance, Medicaid, SSI, the beneficiary's employment and other sources."

3. Am I eligible for an ABLE account?

Passage of legislation is a result of a series of compromises. The final version of the ABLE Act limits eligibility to individuals with significant disabilities with an age of onset of disability before turning 26 years of age. If you meet this criteria and are also receiving benefits already under SSI and/or SSDI, you are automatically eligible to establish an ABLE account. If you are not a recipient of SSI and/or SSDI, but still meet the age of onset disability requirement, you would still be eligible to open an ABLE account if you meet SSI criteria regarding significant functional limitations. The regulations to be written in 2015 by the Treasury Department will have to explain further the standard of proof and required medical documentation. You need not be under the age of 26 to be eligible for an ABLE account. You could be over the age of 26, but must have the documentation of disability that indicates age of onset before the age of 26.

4. Are there limits to how much money can be put in an ABLE account?

The total annual contributions by all participating individuals, including family and friends, is $14,000. The amount will be adjusted annually for inflation. Under current tax law, $14,000 is the maximum amount that individuals can make as a gift to someone else and not pay taxes (gift tax exclusion). The total limit over time that could be made to an ABLE account will be subject to the individual state and their limit for education-related 529 savings accounts. Many states have set this limit at more than $300,000 per plan. However, for individuals with disabilities who are recipients of SSI and Medicaid, the ABLE Act sets some further limitations. The first $100,000 in ABLE accounts would be exempted from the SSI $2,000 individual resource limit. If and when an ABLE account exceeds $100,000, the beneficiary would be suspended from eligibility for SSI benefits and no longer receive that monthly income. However, the beneficiary would continue to be eligible for Medicaid. States would be able to recoup some expenses through Medicaid upon the death of the beneficiary.

5. Which expenses are allowed by ABLE accounts?

A "qualified disability expense" means any expense related to the designated beneficiary as a result of living a life with disabilities. These include education, housing, transportation, employment training and support, assistive technology, personal support services, health care expenses, financial management and administrative services and other expenses which will be further described in regulations to be developed in 2015 by the Treasury Department.

6. Where do I go to open an ABLE account?

Each state is responsible for establishing and operating an ABLE program. If a state should choose not to establish its own program, the state may choose to contract with another state to still offer its eligible individuals with significant disabilities the opportunity to open an ABLE account.

After President Obama signs the ABLE Act, the Secretary of the Department of Treasury will begin to develop regulations that will guide the states in terms of a) the information required to be presented to open an ABLE account; b) the documentation needed to meet the requirements of ABLE account eligibility for a person with a disability; and c) the definition details of "qualified disability expenses" and the documentation that will be needed for tax reporting.

No accounts can be established until the regulations are finalized following a public comment period on proposed rules for program implementation. States will begin to accept applications to establish ABLE accounts before the end of 2015.

7. Can I have more than one ABLE account?

No. The ABLE Act limits the opportunity to one ABLE account per eligible individual.

8. Will states offer options to invest the savings contributed to an ABLE account?

Like state 529 college savings plans, states are likely to offer qualified individuals and families multiple options to establish ABLE accounts with varied investment strategies. Each individual and family will need to project possible future needs and costs over time, and to assess their risk tolerance for possible future investment strategies to grow their savings. Account contributors or designated beneficiaries are limited, by the ABLE Act, to change the way their money is invested in the account up to two times per year.

9. How many eligible individuals and families might benefit from establishing an ABLE account?

There are 58 million individuals with disabilities in the United States. To meet the definition of significant disability required by the legislation to be eligible to establish an ABLE account, the conservative number would be approximately 10 percent of the larger group, or 5.8 million individuals and families. Further analysis is needed to understand more fully the size of this market and more about their needs for new savings and investment products.

10.How is an ABLE account different than a special needs or pooled trust?

An ABLE Account will provide more choice and control for the beneficiary and family. Cost of establishing an account will be considerably less than either a Special Needs Trust (SNT) or Pooled Income Trust. With an ABLE account, account owners will have the ability to control their funds and, if circumstances change, still have other options available to them. Determining which option is the most appropriate will depend upon individual circumstances. For many families, the ABLE account will be a significant and viable option in addition to, rather than instead of, a Trust program.

Please also see our related post - 529A Savings Plans May Help People With Disabilities

Thank You

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529A Savings Plans May Help People With Disabilities

5/28/2015

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In late 2014, the U.S. Congress passed the Achieving a Better Life Experience Act, which created a 529A account to provide tax advantaged benefits for disabled individuals. It is a significant change to the financial planning landscape for special needs beneficiaries, with the potential for helping many families with disabled members.

The 529A is modeled after the Section 529 College Savings Plan, which is widely used for college planning. The 529A account is meant to allow tax advantaged accumulations and distributions for a wide range of expenses for the disabled beneficiary. Here are some specifics about the plans and how they differ from traditional 529s:

The 529A account uses the Social Security definition of disability. In addition it can benefit only people who have been diagnosed with a qualifying disability before age 26.
Like the 529 college plans, the 529A will be set up on the state level. Presumably, the same state agencies that oversee the 529 college plans will be responsible for the 529A, although that may differ from state to state.

There can be only one 529A account per beneficiary, normally in his or her state of residence. That is different from the 529 college plans, for which there is no limitation on which state plan is used, and where the distributions are made.

Spending for a beneficiary can occur only in his or her state of residence. This will allow simplified compliance verification for federal and state agencies.

Contributions in the 529A are with after tax money and are limited to $14,000 a year (in 2015) for each beneficiary from all sources. Individual states may choose to provide additional tax benefits.

Investment growth in the 529A is tax free.

Distributions are tax free so long as they are used for qualified expenses. Otherwise, earnings on distributions are taxed at ordinary income rates with a 10% penalty added. Qualified expenses include housing, transportation, health and wellness, and education.

Having a 529A does not disqualify the disabled individual from federal and state aid, such as Supplemental Security Income or Medicaid, so long as the amount held in the 529A does not exceed $100,000. Should the 529A account balance exceed $100,000, Supplemental Security Income would be suspended, but not terminated. Once the balance falls below $100,000, benefits would be resumed.

The limitations on contributions and on balance levels suggest that the 529A could be used as a hybrid between an investment account and a checking account.

Advantages

The 529A comes with built-in benefits such as low costs (hopefully), tax advantages and the ability to have up to $100,000 in assets without jeopardizing access to public support programs.

The new plan should be attractive to many middle-class families. Similar to the intent of the 529 plan for college bound students, the 529A allows families to set aside money for their disabled loved one, and use it as needed, while limiting the impact of unforeseen expenses on their lifestyle.

Drawback

The 529A has restrictions for annual contributions and maximum balance that may make an account delicate to manage. It is not a vehicle for disabled people to accumulate more than $100,000. In fact due to the relatively low balance limit, the vagaries of market fluctuations that it may be subjected to and the inevitable withdrawals that will occur, many people will want, if they can afford it, to supplement a 529A with a Special Needs Trust.

The 529A is not a perfect vehicle. However, it is a great new tool to help disabled people. It will allow more families to plan support for their disabled family members with an easy-to-use framework that should be relatively low cost and may provide additional funding in the form of tax free earnings. In addition, 529A accounts supplement rather than replace Special Needs Trusts by filling a gap for the period before Special Needs Trusts are funded.

Please also see our related post ABLE Act Overview

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Don't confuse IRS tax laws with Medicaid in regards to "gifts"

5/24/2015

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Both Medicaid and the IRS have their own set of rules about the consequences of making gifts and both apply to any gifts that you make. We often see people getting the two sets of rules confused.

The following will help you understand the different sets of rules the IRS and Medicaid apply to gifts.

IRS Rules on Gift Tax
The definition of "gift" by the IRS - Any transfer to an individual, either directly or indirectly, where full consideration (measured in money or money's worth) is not received in return.

While the IRS definition of what is considered a gift is very similar to that of Medicaid, how it is treated is very different.The lifetime gift exemption amount is not something that will come into play with Medicaid, the new 2015 lifetime gift exemption limits will increase to $5,430,000. Meaning you may make gifts of up to that amount during your lifetime without paying gift tax, however, such gifts must be reported to the IRS on a gift tax return. [anyone concerned with that amount is not applying for Medicaid]. In most situations, transfers of any amount to your spouse, either during lifetime or at death, are not subject to gift tax. The annual gift amount is where many people get confused with regards to Medicaid. The annual gift amount will stay at $14,000 per year, per person, without having to file a gift tax return with the IRS. You can give away $14,000 to as many individuals as you’d like. A husband and wife can each make $14,000 gifts. So a couple could make $14,000 gifts to each of their four grandchildren, for a total of $112,000.

Medicaid Rules on Gifting
The Medicaid rule regarding Disposition of Assets and Fair Consideration refers to"Gifts" or transfers of assets and is described as [when an individual, the individual's spouse or another acting on their behalf disposes of or transfers assets for less than Fair Market Value. Assets include all income and resources]. There are a few exceptions to this also which we'll review below.

If these gifts or transfers occur within 60 months of the application for Medicaid benefits, the individual may be disqualified from receiving benefits for a certain period. This is referred to as a “penalty period”. This penalty period is calculated by dividing the total value of uncompensated gifts or transfers by the penalty divisor of your state [which is equal to the average private patient cost of nursing facility care in your state at the time of application for benefits]. The result is the number of days you will have to wait until you will be eligible for Medicaid to pay for long-term care services. The ineligibility period starts to run on the day the application is otherwise approved. So, the $14,000 gift that's allowed by the IRS may count towards disqualification of Medicaid benefits.

Exceptions

Medicaid allows for exceptions to the Fair Consideration rule as follows;

The individual’s spouse. 55 Pa. Code § 178.104(e)(1)(i)
The individual's child under 21 years of age. 55 Pa. Code § 178.104(e)(1)(ii)
The individual’s child age 21 or older who is blind or permanently and totally disabled

The individual's spouse or to another for the sole benefit of the individual's spouse.
Another for the sole benefit of the individual's spouse, by the individual's spouse.
The individual's child who is under 21 years of age, or the individual’s child age 21 or older who is blind or permanently and totally disabled.
A trust established solely for the benefit of the individual's child age 21 or older who is blind or permanently and totally disabled.

A trust established solely for the benefit of an individual less than 65 years old who is disabled.

NOTE: blind or permanent or total disability of the child must meet SSI criteria specified in 42 U.S.A. § 1382c(a)(3).

Preserving Assets
Although early planning is almost always best, you can preserve a significant amount of assets even if a family member is already in the nursing home with the proper tools.

Example,
Mary’s husband has been in the nursing home for two years. When he entered the facility they had $380,000 in savings and investments. Now with only $183,000 left, Mary would like to know, what can she do to get her husband approved for Medicaid benefits and preserve the money she has left.

Fortunately, Mary can purchase a Medicaid Qualified Annuity, her husband will then be eligible for Medicaid immediately and the remaining $183,000 will be preserved for her. However, Mary could have used the same tool 2 years ago when her husband entered the nursing home, which would have preserved the entire $380,000 of savings for her. [Funeral Expense Trusts] may be used in conjunction with the annuity also]

Hopefully, this will help.

As with all of our posts, the above is not intended to be legal or tax advice. Medicaid and the IRS are extremely complex and confusing.

The above facts pertaining to Medicaid were derived Medicaid rule 440.8 regarding Disposition of Assets and Fair Consideration.

Questions? Email us at [email protected]

Thank You

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Medicaid’s limit for “Community Spouse” Minimum Income Allowance [MMNA] to Increase on July 1, 2015 to $1,991.25

5/20/2015

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Single recipients of Medicaid long-term care services in nursing homes are expected to use most of their income to pay a share of the cost of their nursing home care, commonly referred to as “patient pay liability”. Medicaid then pays the difference between the recipient’s share of cost and the Medicaid payment rate.

Medicaid law was amended in 1988 in response to evidence that at-home spouses [also known as “community spouses”] faced poverty and a radical reduction in their standard of living before their spouses living in a nursing home could qualify for Medicaid. The Medicaid “spousal impoverishment” provisions were put into place to protect the community spouse when the institutional stay of the nursing home resident has lasted or is expected to last at least 30 consecutive days.

Federal law prescribes income protection of a minimum maintenance needs allowance (MMNA) for the community spouse. Federal law prescribes that the MMNA should equal at least 150% of the federal poverty level for a couple and be adjusted every year by the general rate of inflation [The Pennsylvania MMNA is adjusted on July 1st of each year].

The community spouse keeps all of his or her own income plus half of any shared income. If this total is less than the MMNA, then the institutionalized spouse must be allowed to supplement the community spouse’s income in an amount that increases the community spouse’s total income up to the applicable MMNA. If the income level of the community spouse is very low, he or she may receive all of the combined marital income.

Example: Mr. and Mrs. Smith have a joint income of $3,000 a month, $1,700 of which is in Mr. Smith's name and $700 is in Mrs. Smith's name. Mr. Smith enters a nursing home and applies for Medicaid. The Medicaid agency determines that Mrs. Smith's MMMNA is $2,000 (based on her housing costs). Since Mrs. Smith's own income is only $700 a month, they may allocate $1,300 of Mr. Smith's income to her support. Since Mr. Smith also may keep a $60-a-month personal needs allowance, his obligation to pay the nursing home is only $340 a month ($1,700 - $1,300 - $60 = $340).

Conversely, a community spouse with a high total income may receive little or no supplementary income from the institutionalized spouse. In such a case, even if the income of the community spouse is considerable, the Medicaid program cannot require that any of it be applied toward the cost of the institutional spouse’s care.

Medicaid rules provide three pathways for community spouses to obtain a higher MMNA.

First, the allowance may be raised (though only as high as the Federal maximum allowance) for community spouses who show that they have exceptional housing costs, defined as more than 30% of the standard allowance.
Second, they can receive a larger allowance if a state Medicaid hearing finds that exceptional circumstances might otherwise cause them extreme financial hardship.
Third, they may seek a court order for additional support.

Questions regarding Medicaid eligibility? Contact our office, PH: 855.471.6771
Email: [email protected]

Medicaid rules are extremely complex and confusing. We always recommend that you seek the advice of a professional.

Facts and figures are from U.S. Department of Health and Human Services

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State Grants Are Available for Nursing Homes

5/15/2015

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The state recently opened a new grant program to assist state-licensed nursing facilities in providing activities that support, protect and benefit their residents, according to Senator Michele Brooks, Chair of the Senate Aging and Youth Committee.

Under the Long-Term Care Grant program, administered by the PA Department of Health, grants of up to $50,000 will provide funds for one-time-only, time-limited projects of no more than 24 months designed to achieve specific outcomes that benefit nursing facility residents. All licensed nursing facilities in the state are eligible to apply for these grants.

“This is a great opportunity for nursing homes to secure valuable state funding for programs that will benefit their residents,” said Senator Brooks. “The state is looking to support programs that will enhance the quality of life and care for nursing care residents and I encourage all local facilities to apply for this money.”

Grant funds will come from fines imposed by the federal Centers for Medicare and Medicaid Services (CMS) and the Department of Human Services as recommended by the Department of Health when long-term care facilities are in violation of CMS conditions of participation.

Additional information as well as the grant application, can be found by visiting www.health.pa.gov. Under hot topics, click on the link for “Pennsylvania’s Long Term Care Grant program.”

Contact: Mike Hengst (717) 787-1322

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How to help elderly parents with Their Finances

Facts About Autism Spectrum Disorder [ASD]

ABLE Act overview, for people with Disabilities

529A Savings Plans May Help People With Disabilities

Don't confuse IRS tax laws with Medicaid in regards to "gifts"

Medicaid’s limit for “Community Spouse” Minimum Income Allowance [MMNA] to Increase on July 1, 2015 to $1,991.25

State Grants Are Available for Nursing Homes

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