Protection for Spouses

When a spouse enters a nursing home and applies or considers medicaid, there are two broad categories of protections – one that protects “Resources” such as assets and the other “Income” which seeks to assure that the spouse at home has sufficient income to maintain her household.

Resources –  These are determined by “Resource Allowances” for the community spouse “CSRA”

Minimum – $23,184
Maximum – $115,920

How does this apply?  On the day your spouse enters a nursing home intending and is expected to stay permanently your assets are totaled and divided by one-half.   That one-half must fall between the minimum and maximum CSRA.   In other words, if you have $150,000 then the community spouse may keep $75,000.   If you have $300,000 the most you can keep is $115,920. Basically it is one-half up to a maximum of $115,920. The money remaining after this is taken out of the mix is excess resources which must be spent down to qualify for medicaid.  Some of this may be used to shore up the MMNA – see below.
Monthly Maintenance Needs Allowance (Income the spouse in community needs as calculated by the law) “MMNA”.

Minimum – $1,939
Maximum – $2,898

How is this relevant?   If you admit your spouse to a nursing home and are otherwise eligible for Medical Assistance and your shelter and other costs calculate out to the Maximum needs allowance ($2898), then you can take sufficient money from your spouse’s income before paying it over to the home to bring your income up to $2,898.   Basically, it is a calculation that attempts to assure that the spouse at home is able to maintain their household after a nursing home admission.  It barely does permit this.  If your spouse does not have enough income, then it is possible to set additional assets aside that will create the additional income needed by the spouse to bring her up to the MMNA.  This is also possible if there are excess resources which may be converted into additional income so long as it is done within the parameters of the medical assistance rules.