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

Last Updated: 11/16/2018 (unless otherwise noted)

Below are figures for 2019 that are frequently used in the elder law practice, including the figures for Virginia Medicaid spousal impoverishment, the Federal long-term care insurance deductibility limits, edicare premiums and co-pays, Social Security Disability, and Supplemental Security Income.

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 2018, the Federal share of Medicaid outlays nationally is expected to be approximately $407.6 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.

When it comes to key dollar amounts, the amounts that have changed are denoted below:

Virginia/Maryland/DC Medicaid Numbers

Every July, states publish the figures to be used when determining Medicaid eligibility for a married couple, and the limits on income that can be kept by an individual or the well spouse remaining in the home. This year’s figures are as follows:

Divestment Penalty Divisors

Northern Virginia: $9,032
Rest of Virginia: $6,422
DC: $9,456.34
MD: $8,684.00

Individual Resource Allowance

VA: $2,000
DC: $4,000
MD: $2,500

Married Couple Resource Allowance

VA: $3,000
DC: $6,000
MD: $3,000.00 each for first 6 months – $2,500.00 each after 6 months

Monthly Personal Income Allowance for Nursing Home Residents

VA: $40
DC: $70
MD: $77

Shelter Standard

VA: $609
DC: $609
MD: $609

Standard Utility Allowance

VA: $311
DC: $305
MD: $402

Medicaid Home Equity Cap

Minimum: $560,000
Maximum: $840,000

Allowance Available for a Community Spouse

Minimum Community Spouse Resource Allowance (except in Alaska and Hawaii): $24,720
Maximum Community Spouse Resource Allowance (except in Alaska and Hawaii): $123,600
Minimum Monthly Maintenance Needs Allowance (except in Alaska and Hawaii): $2,057.50
Maximum Monthly Maintenance Needs Allowance (except in Alaska and Hawaii): $3,090.00

For CMS’s complete chart of the 2018 SSI and Spousal Impoverishment Standards, click here.

Auxilliary Grant Figures:

2018 Northern Virginia: $1421
2018 Rest of Virginia: $1,230

Veterans Aid and Attendance Figures:

Click here for most current figures

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.

In mid-October, the Centers for Medicare and Medicaid Services unveiled the new rates for 2019. The announcement came a day after the Social Security Administration set a 2.8% cost-of-living adjustment to benefits in 2019.

About 2 million Medicare beneficiaries will pay less than the $135.50 premium for next year due to the “hold harmless” provision. That rule protects certain Social Security beneficiaries from paying more for their Part B premiums. The annual deductible for Medicare Part B beneficiaries will be $185 in 2019, up from $183 in 2018.

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.

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

Medicare Deductibles, Premiums and Co-pays

Medicare Part A Deductible

2019: $1,364 deductible for each benefit period
2018: $1,340 deductible for each benefit period

Medicare Part A Premium

If you are one of the small number of people who don’t qualify for free Part A coverage and decide to purchase it on your own, you’ll pay:

2019: $437 each month
2018: $422 each month

Co-payment for hospital stay, days 61-90

2019: $341 per day
2018: $335 per day

Co-payment for hospital stay, days 91 and up

2019: $682 per day
2018: $670 per day

Co-payment for skilled nursing facility stay, days 21-100

2019: $170.50 per day
2018: $167.50 per day

—–

Social Security and Supplemental Security Income

Social Security is part of the retirement plan of almost every American worker, and this year, those who collect it will be “getting a raise!”

Based on the increase in the Consumer Price Index (CPI-W) from the third quarter of 2017 through the third quarter of 2018, Social Security and Supplemental Security Income (SSI) beneficiaries will receive a 2.8 percent COLA for 2019.

Retirement Earnings Test Exempt Amounts

Under full retirement age*

2019: $17,640/yr. ($1,470/mo.)
2018: $17,040/yr. ($1,420/mo.)
*One dollar in benefits will be withheld for every $2 in earnings above the limit.

The year an individual reaches full retirement age**

2019: $46,920/yr. ($3,910/mo.)
2018: $45,360/yr. ($3,780/mo.)

** The 7.65% tax rate is the combined tax rate paid for Social Security and Medicare. The Social Security portion (OASDI) is 6.20% on earnings up to the applicable taxable maximum amount (see below). The Medicare portion (HI) is 1.45% on all earnings. Also, as of January 2013, individuals with earned income of more than $200,000 ($250,000 for married couples filing jointly) pay an additional 0.9 percent in Medicare taxes. The tax rates shown above do not include the 0.9 percent.

Social Security Disability Thresholds

Non-Blind

2019: $1,220/mo.
2018: $1,180/mo.

Blind

2019: $2,040/mo.
2018: $1,970/mo.

Maximum Social Security Benefit: Worker Retiring at Full Retirement Age

2019: $2,861/mo.
2018: $2,788/mo.

SSI Federal Payment Standard

Individual

2019: $771/mo.
2018: $750/mo.

Couple

2019: $1,157/mo.
2018: $1,125/mo.

Estimated Average Monthly Social Security Benefits Payable in January 2019

All Retired Workers

2019: $1,461/mo.
2018: $1,422/mo.

Aged Couple, Both Receiving Benefits

2019: $2.448/mo.
2018: $2,381/mo.

Widowed Mother and Two Children

2019: $2,876/mo.
2018: $2,797/mo.

Aged Widow(er) Alone

2019: $1,386/mo.
2018: $1,348/mo.

Disabled Worker, Spouse and One or More Children

2019: $2,130/mo.
2018: $2,072/mo.

All Disabled Workers

2019: $1,234/mo.
2018: $1,200/mo.