12670 NW Barnes Road, Ste. 102

Portland, OR 97229

(503) 445-2232

Meredith@nwestatelaw.com

2018 Changes to Medicaid

February 6, 2018

2018 brought changes to Oregon Medicaid for Long Term Care Services. The good news is, we saw an increase in the amount of assets as well spouse is eligible to keep and a slight increase in the monthly needs allowance for the Medicaid recipient.  The new numbers are listed below. In addition to the changes in the Medicaid numbers, there were changes in the definitions for ADLs (Activities of Daily Living).  The goal of these changes was to better define each ADL to determine if a person was eligible for Medicaid.

 

To qualify for Long Term Care Medicaid, a person must meet three criteria: 1) income below $2,250; 2) assets below $2,000 for Medicaid recipient and up to $123,600 for the well spouse; 3) meet certain limits for ADLs.  A person must meet one of the following (1 through 13):

 

1.    Requires Full Assistance in Mobility, Eating, Elimination, and Cognition.

2.    Requires Full Assistance in Mobility, Eating, and Cognition.

3.    Requires Full Assistance in Mobility, or Cognition, or Eating.

4.    Requires Full Assistance in Elimination.

5.    Requires Substantial Assistance with Mobility, Assistance with Elimination and Assistance with Eating.

6.    Requires Substantial Assistance with Mobility and Assistance with Eating.

7.    Requires Substantial Assistance with Mobility and Assistance with Elimination.

8.    Requires Minimal Assistance with Mobility and Assistance with Eating and Elimination.

9.    Assistance with Eating and Elimination.

10.  Requires Substantial Assistance with Mobility.

11.  Requires Minimal Assistance with Mobility and Assistance with Elimination.

12.  Requires Minimal Assistance with Mobility and Assistance with Eating.

13.  Requires Assistance with Elimination.

 

If a person does not meet one of the above, they will not meet the third (ADL) prong of the test.  Medicaid has better defined what the above means. The new rules can be found at http://www.dhs.state.or.us/policy/spd/rules/411_015.pdf.

 

In addition to the new definitions, the financial numbers have changed as well.  

2018 Medicaid Numbers – Oregon

Asset limit for Medicaid recipient       $2,000

Long Term Care Income Cap               $2,250/month

Community Spouse Minimum

     Resource Standard (CSRA)              $24,720

Community Spouse Maximum

      Resource Standard (CSRA)             $123,600

Community Spouse

       Minimum Allowance (MMMNA)   $2,030/month

Community Spouse Maximum

       Monthly Allowance                         $3,090/month

Excess Shelter Allowance                     $609/month

Food Stamp Utility Allowance Used   $454/month

       to Figure Excess Shelter Allowance

Personal needs allowance in

        nursing home                                $61.38/month

Personal needs allowance in              

       nursing home - eligible veteran   $90            

Personal needs allowance in

        community-based care                 $167/month

Personal needs allowance

        for in-home care                            $1,250/month

Room & board rate for community-

        based care facilities                      $583/month

Monthly transfer penalty                     $8,425/month

Well Spouse Asset Limit                       $123,600

 

For information about the above, please call Meredith at 503-445-2232

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