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 […]
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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. […]
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 […]
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 […]
When the Deficit Reduction Act of 2005 changed 42 U.S.C. § 1396p, new restrictions were imposed on promissory notes. Subsection (c)(1)(I) note provides that the purchase of a promissory notes is treated as a transfer subject to the penalty rules unless the note meets the following guidelines: (I) For purposes of this paragraph with respect […]
In Lamle ex rel. Lamle v. Shropshire (W.D. Oklahoma 5/29/2024), a United States District Court upheld a denial of benefits where three Medicaid applicants refused to answer questions about promissory notes. Penelope Lamle, Marilyn Garrison and Maxine Houston each loaned money to others in exchange for a promissory note. Lamle and Garrison made loans to […]
Section 1115 of the Medicaid statute allows sates to test new or existing ways to deliver and pay for health care services in Medicaid and the Children’s Health Insurance Program (CHIP). The home health waivers are designed to meet the needs of people who prefer to get long-term care services and supports in their home […]
Medicaid’s “Any Circumstance” Test for Trusts In case you missed the memo, Medicaid doesn’t like trusts. The rules relating to trusts you create with your money or property are found at 42 U.S.C. § 1396p(d). To put this discussion in context, we’ll begin with the sections relevant to the “any circumstances” test, but the full […]
Long-Term Care Partnership Policies One example of good planning is purchasing long-term care insurance. The greatest risk to non-taxable estates (those under $12.9 million) is the cost of long-term care. With long-term care insurance, you can shift that risk to an insurance company. A partnership policy is a special long-term care insurance policy that protects […]
