Key Elder Law Dollar Amounts – Medicaid / SSI Supplements / Medicare / SS Benefits

Last Updated: 2/16/2022 (unless otherwise noted)

Below are figures for 2022 that are frequently used in the elder law practice, including the figures for spousal impoverishment, penalty divisors, and more, for Virginia, MD, and DC. Medicare premiums and co-pays, Social Security Disability, and Supplemental Security Income are also covered.

Medicaid Figures:

Medicaid is the primary funding source for long-term care for millions of disabled and elderly middle-class Americans, providing vital long-term care coverage to those who qualify for the benefit.

Although the federal government establishes general guidelines for the program, states design, implement, and administer their own Medicaid programs. The federal government matches state expenditures on medical assistance based on the federal medical assistance percentage, which can be no lower than 50 percent. In fiscal year 2019, total Medicaid spending was $616 billion — all of which is of course funded by your tax dollars. If you are smart enough to do legal planning to get some of these tax dollars back to pay for your long-term care when you need it, it’s ethically no different than income tax planning, when you try to get the biggest income tax refund every year.

Virginia/Maryland/DC Medicaid Numbers

Divestment Penalty Divisors (as of 2/26/2022)

Northern Virginia Penalty Divisor: $9,032.00/month – Northern Virginia (Alexandria, Arlington, Fairfax, Falls Church, Loudoun, Manassas, Prince William)

Rest of Virginia Penalty Divisor: $6,422/month

DC Penalty Divisor: $12,731.91/month

Maryland Penalty Divisor: $10,190/month

Individual Resource Allowance

VA: $2,000

DC: $4,000

MD: $2,500

Married Couple Resource Allowance

VA: $4,000

DC: $6,000

MD: 3,000 per spouse; after 6 months, $2,500 per spouse.

Monthly Personal Maintenance Allowance

VA: $40 (Community-Based Care PMA is 165% of SSI Level (rounded up to the nearest dollar, so $1,388 for 2022 based on SSI Level of $841 – click here – M1470.410)

DC: $70

MD: $83

Shelter Standard

VA: $646.50

DC: $646.50

MD: $646.50

Standard Utility Allowance

VA: $402

DC: $305

MD: $431

Medicaid Home Equity Cap

Minimum: $636,000 (VA and MD)

Maximum: $955,000 (DC)

Community Spouse Resource Allowance

Minimum Community Spouse Resource Allowance (except in Alaska and Hawaii): $27,480

Maximum Community Spouse Resource Allowance (except in Alaska and Hawaii): $137,400

Community Spouse Monthly Maintenance Needs Allowance

Minimum Monthly Maintenance Needs Allowance (except in Alaska and Hawaii): $2,177.50

Maximum Monthly Maintenance Needs Allowance (except in Alaska and Hawaii): $3,435

For CMS’s complete chart of SSI and Spousal Impoverishment Standards, click here.


SSI Supplements:

Virginia Auxiliary Grant Figures for Assisted Living Facilities:
As of 1/1/2022: Northern Virginia Income Limit: $1,850 (+ $20 income exclusion)
As of 1/1/2022: Rest of Virginia Income Limit: $1,609 (+ $20 income exclusion)
Personal Maintenance Allowance: $82

DC Optional State Supplemental Payment (OSSP) Program for Assisted Living Facilities:
As of 1/1/2022: Income Limit for individuals: $1,501
As of 1/1/2022: Income Limit for married couple: $2,917

Maryland Assisted Living Subsidy:
Recipients must be in need of the nursing home level of care.
Net monthly income may not be higher than 60 percent of the State median income.
The maximum subsidy paid directly to the provider is $1000/month.​
$130/month personal allowance deduction


Veterans Aid and Attendance Figures:

Click here for all Veterans Aid and Attendance Figures and Rules.


Gift and Estate Tax:

Gift Tax Annual Exemption 2022:  $16,000

Gift Tax Lifetime Exemption:  $11.7 million


Medicare:

Medicare is the federal government program that provides health insurance if you are 65+, under 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or under 65 and with End-Stage Renal Disease (ESRD). Medicare has been protecting the health and well-being of American families and saving lives for five decades.

The Centers for Medicare & Medicaid Services (CMS) recently released the cost-of-living-adjustment of 5.9% in 2022, which is used to determine 2022 premiums, deductibles, and coinsurance amounts for the Medicare programs.

Sizeable COLA increase for 2022

Yes, you read that right. The cost-of-living adjustment for 2022 will be 5.9%, a huge increase on the 1.3% adjustment that was in place in 2021. This will be the biggest increase seen in the United States in 40 years (since 1982).

So, given that the average retiree received a monthly Social Security check of $1,565 in 2021, next year’s bump means that they will have an additional $92 a month available in 2022, boosting the payment to $1,657.

Below are the numbers that have changed for the coming year:

Medicare Part A

Medicare Part A covers primarily inpatient hospital care. Most Medicare beneficiaries (99%) do not pay a premium for Medicare Part A, as long as they have at least 40 quarters of qualifying employment. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.

Medicare Part A Premium Increases in 2022

For those who have not paid the required amount of Medicare taxes, Part A premiums will most likely increase. Those who have paid Medicare taxes for 30 to 39 quarters will likely see their Part A premium increase from $259 per month in 2021. And those with fewer than 30 quarters worth of Medicare taxes will likely see a jump from the current rate of $478 in 2021. The amounts listed below are all projected, based on the 2022 COLA. The exact amounts are TBD and I will update them on our website as soon as they become available.

2022 Part A premium

  • No premium – for most beneficiaries who paid into Medicare through payroll taxes.
  • $274/month – for those who worked / paid into Medicare between 7.5 and 10 years (up from $259/month in 2021)
  • $499/month – for those with a work history of less than 7.5 years (up from $471/month in 2021)

2022 Part A deductible

  • $1,556 (up from $1,484 in 2021)
  • Covers up to 60 days in the hospital.
  • Deductible is per benefit period, NOT per year. Once a beneficiary has been out of the hospital for at least 60 days, a new benefit period would start if and when they needed to be hospitalized again.
  • Supplemental coverage, including Medigap plans, will pay some or all of the Part A deductible on your behalf.

2022 Part A coinsurance:

  • $389 per inpatient day (days 61-90 in the benefit period for which the deductible applied; up from $371 per day in 2021)
  • $778 per inpatient day for day 91 and beyond during the benefit period (up from $742 per day in 2021). These are your lifetime reserve days, and you only get 60 of them over the course of your lifetime. They only start to be used up once you’ve spent 90 days in the hospital during a single benefit period. But if you do use up all your lifetime reserve days and don’t have supplemental coverage, you’re responsible for all hospital costs after the lifetime reserve days are used up.
  • Medicare Part A covers 100% of the cost of rehabilitation in a skilled nursing facility for the first 20 days immediately following a minimum three-night inpatient hospital stay. After the first 20 days, your skilled nursing facility coinsurance for days 21-100 in 2021 is $50 per day (projected to increase to $194.50 per day in 2022), but most people have a Medigap plan that covers all or part of days 21-100. After that 100 days, Medicare no longer covers any skilled nursing facility charges.

Medicare Part B Premiums/Deductibles (2022 Summary)

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.

Each year the Medicare premiums, deductibles, and copayment rates are adjusted based on Medicare’s overall program costs and other health insurance factors.

2022 Part B and Part D Premiums:

  • The standard Part B premium for 2021 is $148.50 per month. It has not yet been finalized for 2022, but the Medicare Trustees Report projects a 2022 Part B premium of $158.50/month.
  • High-income enrollees pay a higher Part B premium. The high-income threshold begins at $88,000 for an individual and $176,000 for a couple as of 2021 (determination based on 2019 income). For 2022, the high-income threshold is projected to increase to $91,000 for an individual and $182,000 for a couple (determination based on 2020 income). See the table below for the 2021 figures. We will update these tables on our website as soon as the new numbers are released.

2021 Medicare Part B Premiums By Income

The standard Part B premium amount in 2021 is $148.50. If your modified adjusted gross income, as reported on your IRS tax return from 2 years ago, is above $88,000 for an individual, or above $176,000 for a jointly filing household, then the IRMAA (Income Related Monthly Adjustment Amount) assessment increases the 2021 Part B and Part D premiums.

2021 Medicare Part D Premium By Income

Part B premiums are also higher (due to a penalty) for some beneficiaries who delayed their enrollment.

2022 Part B deductibles:

In 2022, the Part B deductible will be

$217 (up from $203 in 2021). Enrollees who receive Part B-covered treatment during the year must pay the Part B deductible before Medicare starts to pick up 80% of the cost of the care.

2022 Part B coinsurance:

  • Once you’ve paid your Part B deductible, you’ll be responsible for 20% of the Medicare-approved amount for the Part B services you receive, and there’s no limit on how high your coinsurance bills can get. But Medigap plans cover some or all of the Part B coinsurance.

How are Medicare Advantage premiums changing for 2022?

The Centers for Medicare & Medicaid Services (CMS) released the 2022 premiums, deductibles and other key information for Medicare Advantage and Part D prescription drug plans in advance of the annual Medicare Open Enrollment to help Medicare enrollees decide on coverage that fits their needs. The average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared to $21.22 in 2021, while projected enrollment continues to increase. The average 2022 premium for Part D coverage will increase to $33 per month, up from $31.47 in 2021.

Keep in mind that although Medicare Advantage plans are generally much less expensive then having Original Medicare with a Medigap / Medicare Supplement plan, and may offer extra bells and whistles, they are also very limited in coverage options compared to Original Medicare with a Medicare Supplement plan. For example, most Medicare Advantage plans require you to only use doctors and hospitals and rehab centers and nursing homes that are “in-network” with that plan, typically providing an extremely limited range of options. If you travel or have homes in more than one state, you will not be able to receive coverage if you get sick while you are out of your Medicare Advantage coverage area.

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Social Security and Supplemental Security Income

The Social Security Administration announced last month that benefits for about 70 million Americans will increase by 5.9% in 2021. The increase in benefits is a cost-of-living adjustment that will begin in January of the new year.

The Social Security Act ties the annual cost-of-living adjustment increases to the Consumer Price Index, which is determined by the Department of Labor’s Bureau of Labor Statistics.

Most Social Security and SSI beneficiaries will be able to view their cost-of-living adjustment notice online through their personal My Social Security account. In order to create an online account, beneficiaries can go to www.socialsecurity.gov/myaccount.

For more information on how the cost-of-living adjustment increases are calculated, visit www.socialsecurity.gov/cola or read my recent article on the subject.

Provided by the SSA, other important information for the 2022 year is as follows:

Retirement Earnings Test Exempt Amounts

Under full retirement age*

2022: $19,884 /yr. ($1,657/mo.)

2021: $18,780/yr. ($1,565/mo.)

*One dollar in benefits will be withheld for every $2 in earnings above the limit.

The year an individual reaches full retirement age**

2022: $51,960/yr. ($4,330/mo.)

2021: $50,520/yr. ($4,210/mo.)

Social Security Disability Thresholds

Non-Blind:

2022: $1,350/mo.

2021: $1,310/mo.

Blind:

2022: $2,260/mo.

2021: $2,190/mo.

Maximum Social Security Benefit: Worker Retiring at Full Retirement Age

2022: $3,345/mo.

2021: $3,148/mo.

SSI Federal Payment Standard

Individual:

2022: $841/mo.

2021: $794/mo.

Couple:

2022: $1,261/mo.

2021: $1,191/mo.

Estimated Average Monthly Social Security Benefits Payable in January 2022

All Retired Workers:

2022: $1,657/mo.

2021: $1,565/mo.

Aged Couple, Both Receiving Benefits:

2022: $2,753/mo.

2021: $2,599/mo.

Widowed Mother and Two Children:

2022: $3,187/mo.

2021: $3,009/mo.

Aged Widow(er) Alone:

2022: $1,553/mo.

2021: $1,467/mo.

Disabled Worker, Spouse and One or More Children:

2022: $2,383/mo.

2021: $2,250/mo.

All Disabled Workers:

2022: $1,358/mo.

2021: $1,282/mo.

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