Nursing Homes Costs

Daily costs range from $295 to $320 (2020) depending on location and other factors. Seniors who live in nursing homes in Michigan will find there are several ways in which to pay for such care. Long term insurance is one option. However, most policies do not pay the full daily cost and there may be time restrictions and maximum benefit amounts. Some seniors self-pay by selling their assets such as a home or business, until they have no money left. (Not our client’s!) Still, other seniors rely on Medicaid to pay for their stay in a nursing home. Medicaid is a federal program that is need-based and is the government’s answer to paying for skilled nursing care. At The Law Offices of David L. Carrier, our goal is to qualify you legally, ethically, and morally for Medicaid; to preserve as much of your life savings for you, so that your choices matter.

We get questions from families about how much money the at-home spouse can keep, the amount the nursing home spouse can keep (if any) and other such important questions when applying for Medicaid.

Here are some 2021 Medicaid numbers:

Monthly Maintenance Needs Allowance: $2,155 – $3,259.50

• Applies when: One spouse lives in the nursing home and the other spouse (the “Community Spouse”) lives outside of the nursing home.
• Definition: Maximum income each month that the Community Spouse may keep. If both spouses combined monthly income is lower than the minimum amount, then the Community Spouse keeps all the income (and it may be possible to expand the resource allowance so the Community Spouse can keep more than $130,380).

Minimum Community Spouse Resource Allowance: $26,076

• Applies when: One spouse lives in the nursing home and the other spouse (the “Community Spouse”) lives outside of the nursing home.
• Definition: Minimum amount of assets that the Community Spouse may keep. If a couple’s combined total assets are below this amount, then the Community Spouse keeps all the assets.

Maximum Community Spouse Resource Allowance: $130,380

• Applies when: One spouse lives in the nursing home and the other spouse (the “Community Spouse”) lives outside of the nursing home.
• Definition: Maximum amount of assets that the Community Spouse may keep in most situations. The Community Spouse may keep the lesser of ½ of the total assets or $130,380. This amount may be higher (using a formula from the state) if the couple’s combined income is less than $3,259.50 per month.

Monthly Personal Needs Allowance: $60

• Applies when: A person is receiving Medicaid benefits while living in the nursing home.
• Definition: Monthly dollar amount that a Medicaid recipient may keep for personal items which Medicaid does not cover (e.g., haircuts). Thirty dollars ($30) more may be available for veterans.

Divestment Penalty Divisor: $9,560

• Applies when: A potential Medicaid recipient transfers assets.
• Definition: This figure, based on the statewide average of monthly nursing home costs, is used to determine the length of time an individual or couple is ineligible for Medicaid benefits because of transfers they have made.

Every divestment, no matter how small, triggers a penalty and denial of benefits.

Resource Allowance for an Individual: $2,000

• Applies when: A single person living in the nursing home applies for Medicaid benefits.
• Definition: Maximum amount of assets a single person may own and still qualify for Medicaid benefits.

Resource Allowance for a Couple: $3,000

• Applies only when BOTH spouses reside in a nursing home.
• Definition: Maximum amount of assets a couple may own and still qualify for Medicaid benefits. If one spouse has received Medicaid benefits for more than one (1) year and then the other spouse moves to a nursing home and applies for benefits, a different rule may apply.

IMPORTANT: You do not have to spend down your life savings to qualify for Medicaid. There are legal and ethical strategies that an expert Elder Law attorney can utilize, to get you the benefits you’ve earned.