Nursing home Medicaid is a benefit from the Federal government that is administered by the Georgia Department of Community Health. Nursing home Medicaid pays for all or the majority of the cost of a nursing home for those who have a medical need for nursing home care. Along with showing the medical need for nursing home care, applicants for nursing home Medicaid must satisfy income and assets tests to receive payment of nursing home care. These income and asset qualifications are complex, and the guidance of an experienced elder law attorney should be sought in determining how to best meet the tests to obtain nursing home Medicaid as soon as possible.
Along with the income and asset test for nursing home Medicaid, there is an amount called Patient Liability that the Medicaid recipient is required to pay to the nursing home. This Patient Liability amount is typically the nursing home Medicaid recipient’s income minus a $50 personal needs allowance. However, in some cases the Medicaid recipient can reduce or even eliminate the amount required to be paid to the nursing home. Each year, Medicaid issues the amount that a spouse that is not in the nursing home can have as a minimum income. If the spouse has income higher than this minimum income, the spouse not living in the nursing home cannot receive any income from the spouse that is in a nursing home. If when the income of the spouse in the nursing home and the spouse outside of the nursing home are combined and under the minimum amount, the spouse not in a nursing home can receive the entirety of the nursing home spouse’s income. Between these two scenarios, the spouse that is not in a nursing home can receive as much income from the spouse in a nursing home as to raise that spouse’s income to the minimum level set by Medicaid.
Using spousal diversion is an useful tool to reduce the amount owed to Medicaid and ensure that the spouse who is not in a nursing home has adequate income.