Our mom is entering assisted living to be paid for by Medicaid, but Medicaid only pays for the care services in assisted living, not the room and board portion. If my siblings and I pay for my mom’s assisted living rent, will that be counted as income and disqualify her for Medicaid?
Payments by a relative to an assisted living residence for room and board could count as the Medicaid beneficiary’s income, but the answer to this question is state specific. Not all states count family payments to an assisted living residence as income, but some states do. This all comes down to whether a state’s Medicaid agency allows “family supplementation”, or put differently, income supplementation.
In the context of Medicaid-funded assisted living, family supplementation is “supplemental” payments to an assisted living facility on behalf of the Medicaid beneficiary. In this specific case, the payment would be for room and board. If a state allows family supplementation, payments made to the facility by friends and relatives do not count as the Medicaid beneficiary’s income, and therefore, do not impact one’s Medicaid eligibility. To be clear, money should never be given directly to the Medicaid beneficiary to make assisted living payments themselves. It would count as income and could cause Medicaid ineligibility.
Approximately 50% of the states allow family supplementation, but even in the states that allow it, the rules vary based on the state. For instance, some states only allow family payments for an upgrade to a private room, and other states only allow it for services, such as cable television and telephone, that are not included in the cost for room and board. Furthermore, some states do not have a policy about family supplementation.
Prior to a relative making any sort of payment to an assisted living residence, it is vital they are certain how supplemental payments will impact a loved one’s Medicaid eligibility. Without the proper knowledge, making payments could result in Medicaid disqualification, as payments could count as income and push the Medicaid beneficiary’s income over the limit. See state-specific Medicaid income limits.
To find out if income supplementation is allowed in one’s state, and if so, the rules surrounding it, one should contact the Medicaid agency in their state. Contact information can be found here.