As I have previously written, Medicaid does not pay for assisted level of care. If you can qualify, the program is called Special Assistance, and it will help with the cost of an assisted living facility. But it is NOT Medicaid.
One of the main differences is an unforgiving income cap that has not been adjusted since 2009. Until now. Effective January 1, 2023, it goes up.
Special Assistance income caps will, from now on, be subject to the same COLA published annually for Social Security. In 2023, benefits will rise 8.7%.
Since 2009, the gross income (that’s income before any deductions) limit has been $1,247.50 for the general assisted living population, and it has been $1,580.50 for Memory Care.
Effective January 1, 2023, the new gross income limits for the general assisted living resident will be $1,355 and $1,737 for Memory Care. Due to rounding, those limits are likely to be $1,354.50 and $1,736.50.
Well, that’s good news and we’ll take it. What is disappointing is the 2023 COLA is applied to a 13-year-old number. Just for fun, I found a calculator that computes the impact of inflation from any year to the present (fun/depressing to fool around with): $1,247.50 in 2009 (the gross SA number set) would be $1,732.89 today. The SCU gross of $1,580.50 would be $2,195.46. So, the 2009/2023 inflation comparison with the 2023 “raise” is:
Calculated 2009-2023 Inflation Basic: $1,732.89. The new SA Rate: $1,355. That’s still $377.89 behind the inflation adjusted limit from 2009.
Calculated 2009-2023 Inflation Enhanced (Memory Care): $2,195.46. The new SA Rate: $1,717. That’s still $478.46 behind the inflation adjusted limit from 2009.
So, as you can see, SA remains woefully beyond the ravages of inflation since 2009.
Congratulations on you being a Super Lawyers…….we always knew!!!!
Why, thank you!
Does this mean that SA income limits will now rise ever year? Or will the 2023 rates stay in place for many years, like the 2009 rates did? Where is this published online (I don’t doubt you, just curious about the source.) I’m worried that when my father eventually dies, my mother’s survivor benefits (they are divorced) will make her ineligible for SA when the time comes that she needs assisted living. He will be getting $1,289 starting in January. Mom has a life estate on her house and I’m the remainderman. I do not see how it will be possible to avoid selling the house to pay for her AL and that would leave me homeless because I cannot afford rent on my income. Or maybe she will not get survivor benefits since they divorced in 1990. All I know is that I can’t sleep at night for worry over this scenario playing out where the house has to be sold and I end up with nothing.
Yes. SA will rise every year with the Social Security COLA. Your mother should be fine. The official notice can be downloaded here.
Thank you so much for sharing timely information. I do not know of any attorney other than you that supplies information after their service is rendered and the customer walks out the door. Your assistance and guidance helped me through my husband’s admittance to a nursing home facility and legal preparedness for the days to come. Thank you for your diligence in keeping us up-to-date on important issues that affect us.
Thank you, Nancy. That was kind of you.
My CarePatrol of Charlotte team and I diligently work with seniors and their families, as they navigate their important need for care and/or placement in a senior living setting. This may include a need of having someone guide them through the process of Medicaid, its requirements, how a spend down of assets work, placing their house into a trust, etc, etc.
I cannot tell you how much I appreciate finding this information online, in simple terms and posted here on your website. It’s nowhere to be found on the state’s website, which has always puzzled me. It’s is so very helpful, having the updated rate info and also the documentation of the official notice to back it up, which you shared on Dec 29th in the comments section.
From here, I will be adding a printed copy of your article to our handouts, to share with our clients. It’s a very helpful piece, thank you!
I hope to connect with your office further, as our client-families sometimes require the assistance of an elder law attorney and it’s important that we refer them to an office that can truly help them, has empathy and understands their journey.
Again, thank you.
Why, thank you! You may find this piece that I wrote about eight years ago interesting. It is relevant still.
BTW, send me some info on your organization.
What if both persons in a married couple require assisted living? Is income still determined individually or is the couple taken into consideration?
Pick one or the other for assisted living. Private pay for the other.
My mom was on special assistance in 2021 and lost it in 2022..she is in a small assisted living facility. I am helping pay for what she can not. What if she did not have me to do this?? What would happen to her since she can’t go home?
Become a ward of the state.
What happens to the bills that an individual owes when applying for special assistance?
If the person is married, the creditors will come looking for the spouse. If the person is single, unhappy creditors will make noise, send to collections, maybe sue (if there is anything left — like real estate) to come after. If not, they’ll likely write it off.
My organization works with LTC patients and Assisted living and memory care comes up a lot. I always rely on the information you provide to help me understand further. Thank you
Why thank you!