Personal Needs Allowance and Medicare SNF Co-Insurance Amounts for 2019

Posted on December 5, 2018 by Jeff Bostic

The personal needs allowance for nursing facility residents is increased annually by the social security COLA. In the coming year, social security benefits will increase by 2.8 percent, so the personal needs allowance will increase from $99 this year to $102 for the year starting Jan. 1, 2019.  

The personal needs allowance is the amount of monthly income that a Medical Assistance (MA) recipient can retain to purchase products and services not covered by the nursing facility MA payment. Generally, MA recipients must contribute their monthly income, less the personal needs allowance, toward their bill for nursing facility care. 

In addition, each Jan. 1 the Medicare Part A coinsurance for Skilled Nursing Facilities benefits is adjusted. On Jan. 1, the coinsurance amount that residents on Medicare Part A stays must pay for days 21-100 of their stay will increase to $170.50 per day from the current level of $167.50. 

The coinsurance amount is based on one-eighth of the inpatient hospital deductible for Medicare beneficiaries, and the 2019 increase is 1.8 percent.  Skilled Nursing Facility members should make sure that their business office staff are aware of this change before they begin billing for Medicare service days for January 2019.