CMS Releases Annual Updates to Medicaid Eligibility Standards
On Friday, November 15th, the Centers for Medicare & Medicaid Services (CMS) released an information bulletin that provided information about annual updates to the income standards for certain eligibility groups. Many eligibility criteria for older adults and people with disabilities are based on the Supplemental Security Income (SSI) program’s Federal Benefit Rate (FBR), and certain parts of Medicaid require asset tests that are updated each year.
In 2025, the monthly FBR will increase from $943 to $967 (a 2.5 percent increase) and the eligibility groups based on SSI will increase accordingly. Some of these groups include the “300%” eligibility category for many 1915(c) HCBS waivers, which is set at 3 times the FBR or $2,901. Additionally, the resource limit for Medicare Savings Programs (MSPs) such as the Qualified Medicare Beneficiary (QMB) will increase to $9,660 for single individuals and $14,470 for married couples. MSPs are Medicaid categories that pay for Medicare premiums, deductibles, and cost sharing for eligible Medicare beneficiaries. Similarly, other eligibility criteria, such as the home equity disregard and the Spousal Impoverishment standards will increase.
The bulletin with the new limits and additional information is available HERE.
