CHAPTER 9: MEDICARE UPDATE
The 2006 figures for a stay in a skilled nursing facility (i.e., a
nursing home) under the Original Medicare Plan are as follows:
You pay nothing for the first 20 days of skilled nursing care and
$119 for days 21-100; i.e., you pay up to $9,520 for the next 80
days of a stay in a skilled nursing facility.
You are responsible for all costs thereafter.
The 2007
Medicare value for a stay in a skilled nursing facility for days 21
through 100 is $124 per day.
In 2008, those on the original Medicare plan will pay:
$128 per day for days 21-100 in a skilled nursing facility for
each benefit period. This is $4 higher than the 2007 value.
CHAPTER 10: MEDICAID UPDATE -
The average cost of nursing care used by the state of New
Mexico in 2007 is $4,821. This is the value used as a divisor to
compute the Penalty Period for an uncompensated transfer.
The 2008 values set by the federal government are as follows:
The Community Spouse Maximum Resource Allowance in $104,400
The Community Spouse Minimum Resource Allowance in $31,290
The Community Spouse MAXIMUM Monthly Maintenance Needs Allowance in $2,610.
The Community Spouse MINIMUM Monthly Maintenance Needs Allowance in $1,712.
The Recipient's Personal Needs Allowance $58.
Community Spouse Excess Shelter Allowance is $495.
Income CAP $1869
As of Feb, 2007, the New Mexico legislature has opted for
the $500,000 homestead equity limit (see below).
CHANGES MADE BY
CONGRESS IN 2006
Congress passed the following changes to the Medicaid law:
FIVE YEAR LOOK BACK
The Look-back period is extended from three years
to five years.
PENALTY
PERIOD STARTS WHEN YOU APPLY
Under the prior Medicaid law the Penalty Period
started from the day the transfer was made. Under the new law the
Penalty Period begins on the day the Applicant applies for Medicaid,
meaning that the Penalty clock doesn’t start ticking till the
Applicant actually applies. For example, if a person makes an
uncompensated transfer during the five year period before he applies
for Medicaid, the Penalty Period will begin as of the day he applies
for Medicaid.
HOMESTEAD WITH EQUITY OF $500,000 OR MORE
If the equity in the Applicant’s home (current
market value less mortgages and liens) is equal to $500,000 or more,
he will not be eligible to receive Medicaid benefits. States are
given the option of increasing this value to $750,000 or more.
These changes need to be adopted by the states,
so it may take several months before these laws are put into effect.
Check with an Elder Law attorney to determine the status of the
Medicaid law in New Mexico.