Spousal Medicaid

Long Island Medicaid application assistanceMedicaid law has provided special protections for those spouses who are healthy and wish to remain in the community while their husband or wife relocates to a long-term care facility. In 1988, Congress enacted provisions designed to ensure that the spouse who is still living at home will have enough income and resources to remain part of the community. These provisions have come to be known as spousal impoverishment provisions.

 

Essentially, the Medicaid spousal impoverishment provisions will allow a certain amount of the couples’ combined resources to be protected for the spouse who wishes to remain in the community. Sometimes, depending on how much income the community spouse has, the income from the spouse now residing in a long-term care facility can also be set aside for the community spouse’s use.

 

Community spouses are legally allowed to keep all of their own income while having the possibility to retain some of the other spouse’s income if the need for financial support arises. The amount of money that the community spouse is allowed to keep is known as the minimum monthly maintenance needs allowance (MMMNA). While each state’s MMMNA varies, the federal government will set a minimum and maximum amount based on poverty guidelines. Effective as of July 1, 2017, the minimum amount is set at $2,030.00 while the maximum amount is set at $3,022.50. This amount will be excluded when evaluating Medicaid eligibility.

 

Additionally, the community spouse will also be able to keep one-half of the couple’s marital assets. The assets will be measured by looking at the number of assets the needy spouse had on the date that the spouse began their long-term care that lasted at least 30 days. The amount of assets the community spouse is allowed to keep is called the community spouse resource allowance (CSRA). Again, the federal government has set a minimum and maximum amount of assets the community spouse is allowed to obtain. The maximum CSRA is $120,900, and the minimum is $24,180.

 

If the CSRA amount is higher than the maximum amount allotted, the excessive assets will be liquidated to pay for the cost of the nursing home before the needy spouse will be eligible for Medicaid. Excessive MMMNA is distributed differently than CSRA. If the MMMNA amount is higher than the maximum amount allotted, the community spouse will receive no additional income from the nursing home spouse, and the additional amount may be used to defer the cost of the nursing home. However, Medicaid will only ask for a voluntary contribution of 25% of the excess amount, leaving the remaining 75% to the community spouse. While the 25% is considered voluntary, if the community spouse does not voluntarily attribute to the needy spouse’s care, Medicaid may sue for support.

 

In addition to the MMMNA and CSRA maximum amounts, the community spouse is also allowed to retain:

  • The primary residence up to a maximum home equity limit of $828,000. The community spouse needs to still reside in the home.
  • One automobile
  • Essential personal property (i.e. clothing, furniture, telephones, televisions, etc.)
  • $1,500 of cash value of life insurance
  • $1,500 burial account
  • Unlimited pre-paid funeral contracts

Knowing the minimum and maximum amount of assets and income allotted to a community spouse can be overwhelming and confusing at times. Before applying for Medicaid, it is important to go over the application and eligibility process with a professional Medicaid consultant. The Medicaid application and eligibility professionals at P&P Medicaid Consulting, Inc. help Nassau County, Suffolk County, and Queens residents prepare applications for Medicaid eligibility while taking advantage of programs and planning options that will protect their excess income and assets. For more information or to schedule a consultation, call our Long Island, New York Medicaid consulting office at (516) 541-4770 or fill out our contact form.

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