The Pennsylvania Department of Human Services has revised the dollar amounts it uses to calculate eligibility for Medical Assistance Long-Term Care benefits (MA-LTC benefits). These cost-of-living inflation adjustments to Medicaid dollar amounts occur quarterly, effective January 1, July 1, and October1 of each year.
1. Penalty Divisor. The daily transfer penalty divisor increased from $321.95/day to $330.19/day. This new penalty divisor is to be used when calculating transfer penalties for Medicaid applications filed on or after January 1, 2018.
To illustrate the use of the penalty divisor, assume an Applicant for MA-LTC benefits makes a gift (or other transfer for less than fair market value) in the amount of $10,000 within the 60 months look-back period. Further assume that the gift is not exempted from the transfer penalties. Such a gift will result in to 30 days of ineligibility for MA-LTC benefits. ($10,000 divided by $330.19 equals 30.28 days; the partial day of ineligibility is ignored under applicable rules.)
2. Spousal Impoverishment. Spousal impoverishment guidelines have been adjusted as follows:
a. The minimum community spouse resource allowance (“CSRA”) for 2018 is $24,720.
b. The “standard” maximum CSRA is $123,600.
3. Home Equity Limitations.
a. For a married recipient, there is no cap on the dollar amount of home equity.
b. For a single applicant, the limit on home equity is now $572,000.
4. Home Maintenance Deduction. The home maintenance deduction for individuals applying for MA-LTC benefits for short-term stays has been increased to $772.10/month, for up to 6 months.
5. Aging Waiver Program. The income cap for access to the Aging Waiver program is $2,250/month in gross income. This $2,250 figure is also the cut-off for determining whether a MA-LTC applicant/recipient will be permitted to retain $8,000 in non-excluded resources or only $2,400. If monthly gross income exceeds $2,250 per month, then the individual’s resource limit is only $2,400, not $8,000.
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