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When applying for Medicaid, the nursing home spouse (called the Institutionalized Spouse) is often a joint owner (or sole owner) on checking, savings and other acounts. Should those resource be taken out of the name of the Institutionalized Spouse? The answer is generally “yes,” but it requires some context and some qualifications. The context and […]

Another “option” that may be considered in appropriate cases is divorce. Deeming between spouses terminates when the marriage terminates. In most cases, this “option” should be avoided because the emotional turmoil associated with divorce is significant and the CSRA can be set by court order, see § 1396r-5(f)(2)(iv) and (f)(3). Divorce also prevents an applicant […]

MCCA includes a mechanism for increasing both the CSRA and the MMMNA in certain cases. The methods by which this can be effected are described in 1396r-5(e), (d)(5) and (f)(3). Blumberg v. Tennessee Department of Human Resources, 2000 WL 1586454 (Tenn.Ct.App.) was a case where a Community Spouse sought a court adjustment of the default […]

Some couples might consider reducing the size of the marital estate by giving their resources away. Frequently this is the result when the plan is “home-made.” However, transfers for less than fair market value, including complete and partial gifts) trigger a period of ineligibility. 42 U.S.C. 1396p(c). It does not matter whether the applicant or […]

While nursing home bills accrue, the healthy or well spouse, known as the “Community Spouse,” [Note 1] struggles to identify and keep income and resources that are necessary to support herself. [Note 2]. To remedy this situation, Congress enacted spousal impoverishment provisions as part of the Medicare Catastrophic Coverage Act of 1988 (“MCCA”). [Note 3]. […]

The standards for the 2022 Community Spouse Resource Allowance and Community Spouse Monthly Income Allowance have been updated in the document below:

Every year the Supplemental Security Income (SSI) benefit rate and Medicaid resource allowances are updated. For 2022, the federal benefit rate increased by 5.9%. There was no change in the SSI benefit rate. The SSI monthly benefit increased to $841. This means the Medicaid income cap increases to $2,523 of gross monthly income. The one-third […]

H.R. 1717, known as the Protecting Married Seniors from Impoverishment Act of 2021, and a companion bill in the Senate (S.1099) would require States to extend Community Spouse Resource and Income allowances to couples needing in-home care. A temporary modification extending these protections was already in place through the Consolidated Appropriations Act, 2021 (Pub. L. […]

Increase CSRA in Superior Court, followed by Application and Fair Hearing. After admission to a nursing home, but prior to application for Medicaid, the Superior Court in Glascock County issued an order setting aside all of Petitioner’s marital resources for the Community Spouse’s benefit for the purpose of generating sufficient income to reach the MMMNA. […]

Community Spouse Resource Allowance administratively raised. Evidence was stipulated that the combined marital income of the couple did not result in post-eligibility income for the Community Spouse that equaled or exceeded the MMMNA. Therefore, the Community Spouse Monthly Income Allowance (CSMIA), 42 U.S.C. § 1396r-5(d)(1)(B), was inadequate to raise the Community Spouse’s post-eligibility income to the […]

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