Saint Augustine, FL asked in Elder Law for Florida

Q: Where on the Medicaid application does one declare an allowance for costs of Part B and Part D Premiums?

Medicaid forces an applicant to declare Gross Social Security as MAGI, before SS deductions rather than net. I have seen no references to "allowances" nor "spend down" to equalize this income/expense inequality by elsewhere declaring SS premiums as deductions. That said, a nursing home resident could be left with a Patient Responsibility higher than her total available funds each month by the amount of his/her SS deductions. (personal needs allowance set aside as irrelevant for this). How does one in LTC pay for something twice?

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1 Lawyer Answer
Jason E. Neufeld
Jason E. Neufeld
  • Elder Law Lawyer
  • Aventura, FL
  • Licensed in Florida

A: If you are applying for ICP Medicaid (the program that pays for nursing home care) and are approved, Medicaid will cover Part B premiums. The Medicaid recipient will also be enrolled in Medicaid managed health insurance plan to cover prescriptions.

Spenddown is a concept that refers to someone who has too much by way of assets (i.e. over $2,000 in countable resources) and needs to legally and ethically transfer those assets so as not to trigger the look-back period.

To read more about spenddowns, here is an article I wrote:

Good luck to you and happy new year.

All the best,

Jason Neufeld | 305.931.0478

1 user found this answer helpful

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