Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Cost Sharing Requirements


  • For persons in Group B, there is a cost sharing requirement. Once individuals are receiving Elderly Waiver services, if they are living at home, they may keep $752 as a personal maintenance allowance in order to pay room and board and personal expenses. The remaining income, if any, must be paid toward the cost of care.

  • Elderly Waiver clients living in residential care settings also retain $752 as the personal maintenance allowance from which $72 is deducted as their Personal Needs Allowance, leaving $680 for room and board costs, which is the maximum that the state-funded Group Residential Housing supplement program will pay for low-income residents. The remaining income, if any, must be paid toward the cost of care.9

"9, The commissioner shall seek to amend the federal waiver and the medical assistance state plan to allow spousal impoverishment criteria as authorized under United States Code, title 42, section 1396r-5, and as implemented in sections 256B.0575256B.058, and256B.059, except that the amendment shall seek to add to the personal needs allowance permitted in section 256B.0575, an amount equivalent to the group residential housing rate as set by section 256I.03, subdivision 5." (Minnesota Statutes 2003, Chapter 256B.0915, subdivision 2: Spousal impoverishment policies)

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