Every year we release the key dollar amounts that are frequently used in elder law, estate administration and special needs trust planning, including Medicaid figures, Medicare premiums, Social Security Disability, and Supplemental Security Income. Be sure to check back often, as we will add any information that has not yet been released and update the page when changes occur.
Medicaid is the primary funding source for long-term care for millions of disabled and elderly Americans, providing vital long-term care coverage to those who qualify for the benefit. Important figures for 2019 follow:
Medicaid Individual Resource Allowance: $2000.00.
Resource Allowance for a Couple who both reside in a facility: $3,000.00.
Medicaid Community Spouse Resource Allowance:
- Minimum: $25,284
- Maximum: $126,420
Medicaid Monthly Maintenance Needs Allowance:
- Minimum: $2,057.50. Effective 7/1/19: $2,113.75
- Maximum: $3,160.50
Medicaid Monthly Personal Needs Allowance: $50.00/month
Medicaid Divestment Penalty Divisor: $343.85/day, or $10,458.77/month
Medicaid Income Cap Limit: A “Miller Trust,” also known as a “Qualified Income Trust,” is required when income exceeds $2,313.00/month
Principal Residence Equity Limits: Minimum: $585,000; Maximum: $878,000
Community Spouse Monthly Housing Allowance: $617.25. Effective 7/1/19: $634.13
Standard Heating and Utility Allowance: $514.00
For complete information about the 2018 Supplemental Security Income (SSI) and Spousal Impoverishment Standards, see the following chart:
Penalty Information In New Jersey For Medicaid: Individuals in New Jersey are allowed to keep $2,000 when they apply for Medicaid to pay for long term care costs. If applicants own assets in excess of $2,000, they must spend down the amount over $2,000 on care costs before they will be eligible for Medicaid. It is important to note, that individuals are not allowed to give gifts of any amount for a period of 5 years (60 months) prior to applying to Medicaid. This 5 year period is called the “look-back” period.
If a gift of any amount is given in New Jersey during a period of 5 year “look-back” period before applying to Medicaid, a penalty period will be imposed. Medicaid will not pay for care until the penalty period is over. The penalty is calculated by taking the total amount of any gifts given, and dividing it by $10,458, a calculation which yields the number of months before Medicaid kicks in.
The average cost of a private room in a nursing home in New Jersey is $12,000, so penalties can become very costly for a family that has not planned appropriately for Medicaid. If an individual’s assets are more than $2,000, they should learn about Medicaid Planning strategies. If you have multiple assets and are looking to access Medicaid, it may make sense to speak with a Certified Elder Law Attorney in New Jersey.
Veterans Needs-Based Pension Program
The Department of Veterans Affairs (VA) needs-based pension program is available to help financially-needy veterans who suffer from non-service-connected disabilities. There are three (3) levels of VA pension benefits available: (1) the basic pension, (2) “Housebound” benefits and (3) “Aid and Attendance” benefits.
Based upon a veteran’s income, resources and care costs, the VA Pension program can provide up to the following maximum annual and monthly VA pension benefits in 2019:
Source: Veterans Pension Rate Table
Recently, on October 18, 2018, the VA amended the regulations governing the VA pension program, adopting new rules wihich mirror the Medicaid rules. For the first time, eligibility for the pension program requires a net worth determination, establishes a look-back period and imposes penalties for asset transfers. New requirements also identify the medical expenses which may be deducted from countable income for VA’s needs-based benefit programs. The new rules will make qualifying for VA pension benefits more challenging than ever.
Medicare is the federal government program that provides health insurance if you are 65+, under 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or under 65 and with End-Stage Renal Disease (ESRD). Medicare has been protecting the health and well-being of American families and saving lives for five decades.
In mid-October, the Centers for Medicare and Medicaid Services unveiled the new rates for 2019, as set forth below:
Medicare Deductibles, Premiums and Co-pays
Medicare Part A Deductible for 2019: $1,364 deductible for each benefit period
Co-payments for hospital stays:
- Day 1-60: $0 co-insurance
- Day 61-90: $341 per day in 2019
- Day 91 and beyond: $682 per day in 2019
Co-payment for skilled nursing facility stay, days 21-100: $170.50 per day in 2019
Social Security and Supplemental Security Income
The Social Security Administration (SSA) has announced increases in the 2019 cost-of-living adjustment (COLA) for Social Security and Supplemental Security Income (SSI) benefits.
Social Security and SSI beneficiaries will receive a 2.8 percent COLA for 2019, effective December 31.
SSA also announced an increase in the SSA maximum taxable amount to $132,900.
SSI Federal Payment Standard: The federal benefit amount for an individual eligible for SSI in 2019 will increase to $771 per month.The federal benefit amount for an eligible couple will increase to $1,157 per month.
Retirement Earnings Test Exempt Amounts
- Under full retirement age*
2019: $17,640/yr. ($1,470/mo.)
*One dollar in benefits will be withheld for every $2 in earnings above the limit.
- The year an individual reaches full retirement age**
2019: $46,920/yr. ($3,910/mo.)
** The 7.65% tax rate is the combined tax rate paid for Social Security and Medicare. The Social Security portion (OASDI) is 6.20% on earnings up to the applicable taxable maximum amount (see below). The Medicare portion (HI) is 1.45% on all earnings. Also, as of January 2013, individuals with earned income of more than $200,000 ($250,000 for married couples filing jointly) pay an additional 0.9 percent in Medicare taxes. The tax rates shown above do not include the 0.9 percent.
Substantial Gainful Activity (SGA) Thresholds
- Disabled: $1,220/mo. in 2019
- Blind: $2,040/mo. in 2019
Social Security Fact Sheet for 2019 –
Federal and State Estate and Gift Taxes
Federal Estate Tax Threshold: $11,200,000 per person
Federal Gift Tax Exclusion: $15,000.00
NJ Estate Tax Eliminated as of 1/1/2018
NJ Inheritance Tax: Class A & E exempt
Long-Term Care Premium Deductibility Limits for 2019
Premiums for qualified long-term care insurance policies are tax deductible to the extent that they, along with other unreimbursed medical expenses (including Medicare premiums), exceed 10 percent of the insured’s adjusted gross income in 2019.
These premiums — what the policyholder pays the insurance company to keep the policy in force — are deductible for the taxpayer, his or her spouse and other dependents. (If you are self-employed, the tax-deductibility rules are a little different: You can take the amount of the premium as a deduction as long as you made a net profit; your medical expenses do not have to exceed a certain percentage of your income.)
However, there is a limit on how large a premium can be deducted, depending on the age of the taxpayer at the end of the year. Following are the deductibility limits for 2019.
Attained age before the close of the taxable year Maximum deduction for year
40 or less $420
More than 40 but not more than 50 $790
More than 50 but not more than 60 $1,580
More than 60 but not more than 70 $4,220
More than 70 $5,270
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