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
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.