The Estate Recovery Rules vary from State to State. The federal minimum requires states to pursue recovery from the probate estate for medical assistance paid for most long-term care classes of assistance received by individuals 55 years of age and older. Federal law permits enhanced estate recovery, which would reach non-probate assets, and some states […]
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Medicaid is the payer of last resort so applicants have, historically, been required to apply for all other benefits before seeking Medicaid eligibility. On March 12, 2025, Georgia issued the following Memorandum changing that rule: The purpose of this memorandum is to provide notification of the elimination of the “Application for Other Benefits” policy requirement. […]
Effective January 1, 2026, the Community Spouse Resource Allowance will increase to $162,660.00. The combined resource allowance will increase to $164,660.00. The Community Spouse income allowance will increase to $4,066.50. The SSI monthly rate in 2026 will be $994, so the 2026 Medicaid income cap will be $2,982. In general terms, all 2025 rates and […]
There are a few major changes for elders in the One Big Beautiful Bill Act. First, as discussed in numerous articles cited below, it appears that reductions in funding will cause home and community-based services to be limited. This could mean more seniors are forced into nursing homes because they lack support to remain home. […]
Recent Supreme Court Medicaid Case In Medina v. Planned Parenthood South Atlantic (US 6/26/2025), the Supreme Court decided that two plaintiffs did not have a right to use 42 U.S.C. § 1983 to enforce the any-qualified-provider provision in 42 U.S.C. § 1396a(a)(23)(A). The abortion part of the case is not important for our analysis. This […]
Improper Use Spoils Trust Is it possible to spoil a trust by misusing it? The answer was “yes” in S.P. v. Division of Medical Assistance and Health Services (N.J. Super. App. Div. 2025). In that case, a brother wanted to provide housing for his sister. He did this by establishing and funding a trust that […]
2025 Georgia Medicaid Transfer Penalty If an applicant for long-term care Medicaid (e.g., nursing home Medicaid) transfers resources for less than fair market value during the 60-month look-back period, a transfer penalty is calculated. In 2024, the Georgia transfer penalty was $10,025. Effective April 1, 2025, the penalty divisor for Georgia Medicaid applicants has increased […]
Medicaid is critical for individuals with special needs. It pays for things no one else will pay for and it has recently come under fire. The Arc is working to protect Medicaid for its constituents. It is activating advocates to protect services for the disability community. It is also seeking donations to further its efforts. […]
On November 15, 2024, the Centers for Medicare and Medicaid Services posted the 2025 spousal impoverishment standards. These are the standards used to determine how the amount of income and resources that can be diverted to or retained by a Community Spouse. They also tell us the SSI rate and the Medicaid income cap. In […]
