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Dear Advocate…
When determining share of cost, can I count my insurance and Medicare premiums as a deduction?


Dear Advocate:

My wife is in a nursing home and we have submitted an application for Long Term Care Medical. I have been told by Medi-Cal that I am considered the community spouse and that California law allows me to retain a minimum monthly maintenance needs allowance (MMMNA) of $2,898. When determining the share of cost that she owes to the nursing home, can I count my Medicare premiums and other supplemental insurance premiums as a deduction?


Sincerely,
Befuddled in Berkley

Dear Befuddled,

Unfortunately, once your wife is in in nursing home on Long Term Care Medi-Cal, you are considered as part of a separate Medi-Cal Family Budget Unit (MFBU). Therefore, health insurance premiums paid on behalf of the well/community spouse are not allowed as an income deduction from the LTC spouse’s financial budget. Only the institutionalized spouse’s premiums are deducted. If there is one joint payment for a health care or long term care insurance policy for both spouses, then the entire amount can be deducted from the institutionalized spouse’s income. Otherwise, they are in separate MFBUs and the community spouse is not a Medi-Cal applicant or beneficiary, so his/her premiums would not be deducted.

Page Last Modified: July 8, 2014