NOVEMBER 3, 1997 VOLUME 5, NUMBER 18
The federal government has just released new figures for Medicaid, Medicare and Social Security eligibility and benefits for 1998. All of the new numbers take effect January 1, and apply throughout 1998.
Eligibility for Medicaid long-term care (in Arizona, the ALTCS program) requires that the recipient meet residence, citizenship and medical standards, while also having assets below a threshold level. In addition, in 22 states (including Arizona), the applicant must have income of less than a certain amount. In 1998, that “income cap” level will rise by $30, from $1452 to $1482.
Married applicants will qualify for Medicaid long-term care if the total income received by both spouses is less than $2964. If the applicant/spouse has income of less than the $1482 figure, he will still qualify even though the community spouse’s income pushes the couple over the $2964 amount.
Once Medicaid long-term care eligibility is established, the recipient must use most of his income for care. The amount he is permitted to keep for his personal needs increases next year from $72.60 to $74.10. This figure is not universal; several states use other numbers for the personal needs allowance.
Most other important Medicaid numbers either do not change at all or are scheduled to change at other times of the year. For example, the $2,000 asset limitation has not been increased for many years, and the maximum amount which may be retained by a community spouse is not set to be increased until July 1, 1998.
As most seniors realize, Medicare is an insurance program, complete with premium, copayments and deductibles. In fact, Medicare is really two separate insurance programs administered jointly. The main Medicare program, also commonly referred to as “Part A,” covers hospitalization. Few participants are required to pay the Part A premium, but for those who must the cost will increase to $309 from $307.
“Part B” Medicare, covering doctor’s visits, also requires a premium payment. Most participants have their Part B premium deducted from their monthly Social Security checks. Those premiums will remain at $43.80 for 1998.
For Medicare patients who require hospitalization, the initial deductible must be met before Medicare begins payments. In 1998, that deductible will increase from $760 to $764. After the deductible is met, the first 60 days of hospitalization are covered without any copayment; days 61 through 90 will now cost $191 per day (up from $190). After the 90th day of hospitalization, the Medicare patient will be responsible for $382 per day (up from $380/day).
Medicare patients in skilled nursing facilities will continue to receive the first twenty days of coverage without any copayment. For days 21 through 100, the copayment will increase from $95/day to $95.50.
Social Security checks will increase by 2.1% beginning January 1. The maximum Supplemental Security Income (SSI) benefit will rise by $10, to $494/month. For couples, the maximum SSI benefit will increase from $726 to $741. This year’s increase is the smallest since 1986 (when the cost of living adjustment was 1.3%), and the second lowest since automatic adjustments were adopted in 1975.
For some Social Security recipients who continue to work, benefits are reduced. Retirees under age 65 lose $1 of benefits for every $2 earned over $9,120 per year (up from $8,640 in 1997). For those between ages 65 and 69, $1 of benefits is withheld for every $3 of earnings over $14,500 (up from $13,500 in 1997). Social Security recipients over age 69 lose no benefits regardless of earnings.