Many state and federal programs concerning elder care have specific financial requirements you and your family need to know when panning for the future. That is why we compiled a list of important financial thresholds and prerequisites for:

  • Medicaid qualification;
  • Federal long-term care insurance deductibility limits;
  • Premiums and co-pays for Medicare;
  • Social Security Disability, and
  • Supplemental Security Income

Please note that the figures described below are applicable for 2018.

Qualifying for Medicaid

Medicaid is a hybrid state/federal program providing the means for low-income Americans to obtain medical treatment. Under the program, beneficiaries pay low out-of-pocket fees for health services that are paid for by federal dollars. Although the federal government establishes general guidelines for the program, states design, implement, and administer their own Medicaid programs.  The federal government matches state expenditures on medical assistance based on the federal medical assistance percentage, which can be no lower than 50 percent. Below are the most up-to-date financial figures for Virginia, Maryland, and DC:

Divestment Penalty Divisors

  • Northern Virginia:  $8,367
  • Rest of  Virginia: $5,933
  • DC:  $9,456.34
  • MD:  $8,684.00

Individual Resource Allowance

  • VA:  $2,000
  • DC:  $4,000
  • MD: $2,500

Married Couple Resource Allowance

  • VA:  $3,000
  • DC:  $6,000
  • MD: $3,000.00 each for first 6 months – $2,500.00 each after 6 months (if sharing same room) – $2,500.00 each (if separate rooms or facilities)

Monthly Personal Income Allowance for Nursing Home Residents

  • VA:  $40
  • DC:  $70
  • MD: $77


Shelter Standard

  • VA:  $609
  • DC:  $609
  • MD:  $609

Standard Utility Allowance

  • VA:  $306
  • DC:  $305
  • MD: $402

Medicaid Home Equity Cap

  • Minimum: $560,000
    Maximum: $840,000

Allowance Available for a Community Spouse 

  • Minimum Community Spouse Resource Allowance (except in Alaska and Hawaii): $24,180
    Maximum Community Spouse Resource Allowance (except in Alaska and Hawaii): $120,900
  • Minimum Monthly Maintenance Needs Allowance (except in Alaska and Hawaii): $2,030
    Maximum Monthly Maintenance Needs Allowance (except in Alaska and Hawaii): $3,022.50

Key Medicare Dollar Figure

The deductible for Medicare Part A  is $1,340 for each benefit period (in 2018).

Deducting Premiums Paid for Long-Term Care Insurance

Long Term Care Insurance remains one of the most tax advantaged planning solutions available. Not only are the benefits paid tax-free, but policyholders may deduct some or all of their premiums. The IRS announced it will be increasing the amount long term care insurance policyholders can deduct from their 2018 taxes for owning coverage.

  • Age 40 or younger
    • 2018: $410/yr
  • Age 41 to 50
    • 2018: $780/yr
  • Age 51 to 60
    • 2018: $1,560/yr
  • Age 61 to 70
    • 2018: $4,160/yr
  • Over age 70
    • 2018: $5,200/yr

Social Security and Supplemental Security Income

Based on the increase in the Consumer Price Index (CPI-W) from the third quarter of 2016 through the third quarter of 2017, Social Security and Supplemental Security Income (SSI) beneficiaries received a 2 percent COLA in 2018.

Retirement Earnings Test Exempt Amount

If you’re younger than full retirement age, the exempt max is $17,040 per year in 2018. If you made more than this amount, every dollar of additional benefit will be withheld for every additional $2 you earned above the exempt limit. When you reach full retirement age, the exempt max is $45,360.