There are a great many public benefit numbers and tax numbers that are adjusted on an annual basis.  This chapter is designed to make these numbers readily available to Elder Law practitioners.  The following are current numbers for 2014.

I.          2014 FIGURES

            A.         Medicaid

$2,163             Income Cap[1]

$117,240         Maximum Community Spouse Resource Allowance (CSRA)[2]

$23,448           Minimum CSRA[3]

$2,931             Maximum Minimum Monthly Maintenance Needs Allowance[4]

(MMMNA)

$1,966.25        MMMNA (July 1, 2014 until June 30, 2015)[5]

$589.87           Excess Shelter Allowance (July 1, 2014 until June 30, 2015)[6]

$2,000             Maximum Resource Limit (individual)[7]

 

            B.        Social Security

1.5%                For 2014 there has been a 1.5% increase for Social Security Benefits[8]

$2,642             The Maximum Social Security benefit for a single individual for 2014[9]

$721                Supplemental Security Income (SSI) – Single[10]

$1,082             Supplemental Security Income (SSI) – Couple[11]

$361                Supplemental Security Income (SSI) – Essential Person[12]

$8,657.26        Maximum Annual SSI benefit – Single[13]

$12,984.44      Maximum Annual SSI benefit – Couple[14]

$1,070             Substantial Gainful Activity (SGA) – Disabled[15]

$1,800             SGA – Blind[16]

7.65%              Tax Rate Employee[17]

15.30%            Tax Rate Self Employed[18]

$770                Trial Work Period[19]

$117,000         Maximum Social Security Wage Base[20]

$1,200             Quarter of Coverage[21]

 

            C.        Medicare

 

1.         Part A

$152    Medicare Co-Payment – Skilled Nursing Facility (SNF)[22]

$1,216 Hospital Deductible[23]

$304    Per day/Co-Insurance Day 61 -90[24]

$608    Per day/Co Insurance Day 91-150[25]

Part A Premium (for voluntary enrollees only)

$234    With 30-39 quarters of Social Security coverage[26]

$426    With 29 or fewer quarters of Social Security coverage[27]

 

2.         Part B

$147                Medicare Part B Deductible[28]

$104.90           Standard Part B Premium[29]

 

Medicare Part B – Single or Married and Filing Separate Return

Part B Income-Related Premium[30]

 

Beneficiaries who file an individual tax return with income:	Beneficiaries who file a joint tax return with income:	Income-related monthly adjustment amount	Total monthly premium amount
Less than or equal to $85,000	Less than or equal to $170,000	$0.00	$104.90
Greater than $85,000 and less than or equal to $107,000	Greater than $170,000 and less than or equal to $214,000	$42.00	$146.90
Greater than $107,000 and less than or equal to $160,000	Greater than $214,000 and less than or equal to $320,000	$104.90	$209.80
Greater than $160,000 and less than or equal to $214,000	Greater than $320,000 and less than or equal to $428,000	$167.80	$272.70
Greater than $214,000	Greater than $428,000	$230.80	$335.70

 

In addition, the monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at some time during the taxable year are:

Beneficiaries who are married but file a separate tax return from their spouse:	Income-related monthly adjustment amount	Total monthly premium amount
Less than or equal to $85,000	$0.00	$104.90
Greater than $85,000 and less than or equal to $128,000	$167.80	$272.70
Greater than $128,000	$230.80	$335.70

 

Standard Part D Cost-Sharing for 2012[31]

$310                Deductible

$2,850             Initial Benefit Period

$4,550             Donut Hole Threshold

$2.55               Catastrophic cost-sharing:  Generic

$6.35               Catastrophic cost-sharing:  Brand

            D.        Tax

$14,000           Annual Gift Tax Exclusion[32]

$145,000         Gifts to Non-Citizen Spouse[33]

$12,150           Income Level/Maximum Tax Estates and Trust[34]

$406,750         Income Level/Maximum Single Individual Income Tax[35]

$5,340,000      Federal Estate Tax Exemption[36]

$3,950             Personal Exemption[37]

$1,900             FICA Wage Threshold[38] Domestic Workers

$7,000             FUTA Wage Base[39]

$5,500            Maximum IRA Contribution[40]

$1,000             “Catchup” IRA Contribution[41]

$114,000 –

$129,000         Applicable Allowable Limit Roth IRA Single Taxpayer[42]

$181,000 –

$191,000         Applicable Allowable Limit Roth IRA Married Taxpayer Filing

Jointly[43]

0.9%                Medicare Tax on Earned Income over $200,000 – Single, over $250,000 – Married[44]

3.8%                Medicare Tax on Unearned Income over $200,000 – Single, over $250,000 – Married[45]

 

            E.         Long-Term Care Insurance

$330                Exclusion from income taxation of daily LTC insurance benefits[46]

 

Tax Deduction of LTC Premium[47]

$370                40 years old or less

$700                41 to 50 years old

$1,400             51 to 60 years old

$3,720             61 to 70 years old

$4,660             more than 70 years old

 

            F.         Standard and Poor’s 500 Index

2.12% average S&P dividend yield January 14, 2013.[48]

 

            G.        Veterans Aid and Attendance/House-Bound Benefits[49]

1.         Aid and Attendance 

$1,759 per month       Veteran with no dependents

$2,085 per month       Veteran with one dependent

$1,130 per month       Spouse of deceased Veteran with no dependent

            2.         House-Bound Benefits

$1,289 per month       Housebound Veteran, no dependents

$1,615 per month       Housebound Veteran, one dependent

$864 per month          Housebound spouse of deceased Veteran, no dependent

 

II.        EXPLANATION OF TERMS

            A.        Medicaid

1.         Income Cap.  Many states use an income cap to determine eligibility for some or all Medicaid Programs.  These are known as income cap states.  Generally the income cap is calculated at 300% of the maximum federal SSI benefit rate for a single individual.[50]

2.         CSRA.  The Medicaid Catastrophic Coverage Act (MCCA)[51] was designed to avoid impoverishing a community spouse where one spouse is institutionalized.  Some states permit the community spouse to retain all countable resources up to the maximum CSRA.  Other states permit the community spouse to retain one half of the countable resources not to exceed to maximum CSRA and to retain all countable resources up to the minimum CSRA.[52]

3.         MMMNA.   Under MCCA, the Community Spouse is entitled to a Minimum Monthly Maintenance Needs Allowance.[53]  If the income of the Community Spouse falls below the MMMNA, the Community Spouse can retain income from the Institutionalized Spouse to bring the Community spouse up to the MMMNA. Some states permit the Community Spouse to keep all of the income up to the Maximum MMMNA.  In other states, the MMMNA is made up to two components, the basic allowance and the excess shelter allowance.

4.         Excess Shelter Allowance.  Excess Shelter Allowance is calculated by totaling the Shelter Expenses of the Community Spouse.  These expenses are limited to rent, a mortgage (including principal and interest), taxes and insurance, utility expenses, and maintenance charges for condominium or co-op.   Some states use a flat amount or amounts for the utility allowance.

5.         Maximum Resource Allowance.  Medicaid has a maximum resource allowance for single individuals of approximately $2,000.  SSI states follow SSI rules.  The SSI resource limit is $2,000 for an individual and $3,000 for a married couple when both apply for benefits.[54]

 

            B.        Social Security

1.         Cost of Living.  Social Security benefits are indexed to inflation and are adjusted annually to reflect increases in the cost of living.

2.         Maximum Social Security Benefit.  Social Security Benefits fall into three categories: Social Security Retirement, Social Security Disability Income (SSDI) and Supplemental Security Income (SSI).  Social Security Retirement and Social Security Disability Income (SSDI) are based on payments made into the Social Security System by wage earners during their working careers.  SSI is a welfare program.  There is a maximum Social Security Benefit for any single individual.  This is also adjusted annually.

3.         SSI Benefit.  There is a maximum federal benefit for SSI for single persons and a separate maximum for married couples.  Some states provide a state supplement to the federal benefit.  There is also a maximum annual SSI benefit.

4.         Substantial Gainful Activity.  To be eligible for either SSDI or SSI, the applicant must be disabled as defined in the Social Security Act.[55]  The statute references the applicant’s inability to perform “substantial gainful activity.”  Substantial gainful activity is the ability to earn more than a certain amount published by the Social Security Administration (SSA) on an annual basis.  There are two income levels to determine substantial gainful activity.  One is for the general population and one is for blind.

5.         Trial Work Period.  During a trial work period, a Social Security beneficiary receiving disability benefits may test his or her ability to work and still be considered disabled.  Social Security does not consider services performed during the trial work period as showing that the disability has ended until services have been performed in at least 9 months (not necessary consecutive months) in a rolling 60 month period.  Any month in which earnings exceed the trial work period amount is considered a month of service for the individuals trial work period.  The trial work period amount is adjusted annually.

6.         Social Security Wage Base.  There is a Social Security tax imposed on income up to the maximum Social Security Wage Base.  Income in excess of the wage base is not subject to the Social Security tax.[56]

7.         Insured Status.  To be eligible for Social Security Retirement Benefits or Disability Benefits, a worker must have insured status.  This means the wage earner must accumulate a certain number of quarters of coverage.  The wage earner is “fully insured” for life if he or she has 40 quarters of coverage.  The wage earner is currently insured if he or she has 6 quarters of coverage during a 13 quarter period ending with the quarter in which the person became entitled to benefits.  The amount of earnings required for a quarter of coverage is adjusted annually.

 

            C.        Medicare

1.         Medicare Part A.   Medicare is a medical insurance program that pays for a broad range of medical services.  Generally, Medicare Part A covers hospitalization and certain limited coverage in skilled nursing facilities as well as the first 100 days of home care and hospice benefits for the terminally ill.  There are premiums, co-payments, deductibles and maximums per spell of illness.[57]

2.         Medicare Co-Payment – Skilled Nursing Facility.  If a person is eligible for Medicare in a skilled nursing facility, Medicare pays the first 20 days in full but days 21 to 100, the Medicare recipient pays a co-payment and Medicare pays the balance.[58]

3.         Deductible.  Under Medicare Part A, Hospital coverage is limited to 90 days per spell of illness.[59] For 60 days there is a deductible which is adjusted annually.

4.         Co-Insurance.  For the next 30 days of hospitalization, the patient pays co-insurance of 25% of the deductible.[60]  For days 91 to 150 for spell of illness, utilizing “lifetime reserve days,” there is a co-payment of one half of the deductible.[61]

5.         Medicare Part B.   Medicare Part B covers physicians, diagnostic tests, medical equipment, ambulance services, outpatient physical and speech therapist, certain home care and prostheses.[62] Medicare Part B is available to persons over 65 years of age or eligible for Part A and who are receiving SSDI after two years.

6.         Medicare Part B Deductions.  There is a deduction for services covered by Medicare Part B.  The amount of the deduction is adjusted annually.

7.         Premiums.  Under Medicare Prescription Drug Improvement and Modernization Act of 2003 (Medicare Act of 2003), beneficiaries pay premiums depending on their income.  Premiums are adjusted annually.[63]

8.         Medicare Part D.  The Medicare Act of 2003[64] provides a prescription drug benefit known as Medicare Part D. To be eligible, individuals must be eligible for either Part A or Part B of Medicare. Individuals may obtain the prescription coverage either through a standalone prescription drug plan (PDP) or through a Medicare Advantage Plan (MA-PD).

 

            D.        Tax

1.         Annual Gift Tax Exclusion.  Tax payers are permitted to make gifts up to a certain amount each year without any gift tax consequences.  This is known as the annual gift tax exclusion.  The exclusion is indexed to inflation.[65]

2.         Gifts to Non-Citizen Spouse.  The estate and gift tax marital deduction is not allowed for transfers to a spouse or a surviving spouse who is not a U.S. Citizen.[66]  The concern is that the non-citizen spouse will leave the country and avoid federal estate tax.  For federal gift tax purposes, the maximum that a spouse can give to a non-citizen spouse is adjusted annually.

3.         Income Level/Maximum Tax, Estates and Trust/Single Individual Income Tax.  Generally, it is advantageous to distribute income from estates and trusts to individuals rather than pay the tax at the estate or trust tax level. Under the federal Internal Revenue Code, income is taxed on a graduated basis.  The maximum income tax rate is 35%.  The maximum income tax rate for an estate or trust is achieved at a much lower level of income than the maximum tax rate for an individual.[67]

4.         Federal Estate Tax Exemption.  There is an exemption from the federal estate tax for each taxpayer’s estate.  This is sometimes known as the unified credit.[68]

5.         Personal Exemption.  Each taxpayer is entitled to a personal exemption which is adjusted annually.  If a person pays more than 50% of support of a relative and a relative had gross income for the year less than the personal exemption amount and has not filed a joint return with his or her spouse and the person paying the support may claim the relative as a dependant on the person’s federal income tax return.[69]

6.         Federal Insurance Contributions Act (FICA) Wage Base.  Social Security and Medicare Part A taxes are imposed on all employers and employees on cash wages in excess of the threshold in any calendar year.[70]  Social Security Old Age, Survivors, and Disability Insurance (OASDI) taxes are limited to the Social Security wage base.[71]  There is no limit for the imposition of the tax for Medicare Part A.

7.         Federal Unemployment Tax Act ( FUTA) Wage Base.  If an employee receives total cash wages in excess of the FUTA Wage Base in any calendar quarter, Federal Unemployment Taxes must be withheld.[72]

8.         Deductible Contribution Traditional IRA.  Taxpayers are permitted to take a tax deduction for contributions to a traditional IRA.  The deductible amount is $5,000 for 2012.  In addition, taxpayers 50 years and over are entitled to a “catch up” contribution of $1,000 per year.[73]  In calendar year 2012, a maximum deductible contribution is indexed to inflation in increases in multiples of $500.[74]

9.         Applicable Dollar Limit Roth IRA.  Generally a Roth IRA is treated in the same manner as a Traditional IRA.  However, no deduction is allowed for contributions.  Contribution limits are the same as for Traditional IRAs.  To be eligible to contribute to a Roth IRA, the bona fide adjusted gross income cannot exceed the applicable dollar amount.[75]

 

            E.         Eligible Long-Term Care Insurance

1.         Exclusion from Taxable Income.  A person who is insured under a qualified long-term care insurance policy is entitled to an exclusion from taxable income a daily amount of long term care insurance benefit.  This is adjusted annually for inflation.

2.         Premium Deduction.  A portion of the premium for long-term care insurance is deductible as a medical expense.  The amount of the allowable deduction depends on the age of the policy holder and is adjusted annually.[76]

 

            F.         Standard and Poor’s 500 Index

The Standard and Poor’s 500 Index (S&P 500) is an index consisting of 500 stocks chosen for market size, liquidity and industry grouping, among other factors.  The S&P 500 is designed to be a leading indicator of U.S. equities and is meant to reflect the risk/return characteristics of the large-cap universe.  Companies are selected by a team of analysts and economists at Standard and Poor’s.  The S&P 500 is a market-value weighted index – each stock’s weight in the index is proportionate to its market value.  The front-end yield is the average dividend yield for the entire group of stocks.[77]

 

            G.        Veterans Aid and Attendance/House-Bound Benefits

1.         Aid and Attendance.  A Veteran or the spouse of a deceased Veteran may qualify for Veterans Aid and Attendance benefits.  Essentially, the claimant must be so helpless as to require the aid of another person to perform the functions required by everyday living.  The need for A&A need not be permanent.  Aid and Attendance is a monthly check from the Veterans Administration to the Veteran.  It may be used to pay for a health companion, friend or relative who is caring for an elderly Veteran or the Veteran’s spouse.  It is particularly useful for eligible Veterans in assisted living facilities, because these funds can be used to offset the cost of the assisted living facility.

2.         House-Bound Benefit.  House-bound benefits are available to Veterans who are totally and permanently disabled.  The Veteran must be permanently house-bound.  If a Veteran is 65 or older, he is presumed to be disabled.  No disability rating is required, but the VA will require a physician’s affidavit regarding the claimant’s condition.  The Veteran is entitled to HB benefits, if he or she has a disability rated at 100% disabling under the VA rating schedule and the Veteran is substantially confined to home.[78]  If the Veteran has a 100% disability with an additional disability independently ratable at 60% or more, house-bound is not a factor.[79]

 

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