Florida Medicaid Increases the Monthly Personal Needs Allowance
Effective July 1, 2014, the monthly personal needs allowance for Florida Medicaid participants residing in a skilled nursing facility (the nursing home) increased from $35 per month to $105 per month. The personal needs allowance is the amount of income that the Medicaid recipient can keep each month for their personal needs such as clothing, a haircut, toiletries and other items not paid for by either Medicaid or Medicare.
When a single recipient is accepted into the Florida Medicaid long-term care program for skilled nursing facilities (ICP Medicaid), he or she has to pay part of the monthly cost of care in the skilled nursing facility. This is called the patient responsibility. The amount of the patient responsibility is calculated by taking the recipient’s gross monthly income and subtracting the personal needs allowance, as well as expenses such as the amount of the monthly premium for a Medicare supplemental policy and the amount of the monthly premium for a Medicare Part D policy. The amount of gross income remaining after those deductions is the amount of income paid to the skilled nursing facility by the Medicaid recipient as his or her patient responsibility.
For a married participant who still has a spouse residing in the community, an additional deduction from the monthly gross income may be made if the community spouse receives less than a minimum amount of monthly income on his or her own. This additional deduction from the gross monthly income of the spouse living in the skilled nursing home is designed to make sure that the community spouse has an acceptable minimum amount of income for his or her needs each month.
The news of the increase in the personal needs allowance for Florida Medicaid recipients residing in a skilled nursing facility is welcome news for the recipients and their families.