Medicaid’s Spousal Impoverishment Protection Law

The Spousal Impoverishment Protection Law applies for nursing home admissions occurring on or after September 30, 1989. Protection under the law applies to nursing home, in-home and community type care services under the Medicaid Aged and Disabled Waiver.

The purpose of the law is to allow the community spouse to keep some of the couple’s income and assets while still qualifying the nursing home spouse for Medicaid. It prevents a community spouse from having to deplete all the couple’s assets in order to qualify their spouse for Medicaid.

For the purposes of Medicaid eligibility, the term “community spouse” refers to the spouse who does not require hospitalization or in-home nursing care.

During the application process, a “snapshot” of the couple’s assets is taken in order to determine the community spouse’s share of the family’s resources. For purposes of Medicaid, “resources” refers to the couple’s assets.

The snapshot reflects the couple’s assets at the time of the Medicaid applicant’s FIRST continuous (minimum 30 days) institutionalization in either a nursing facility or hospital.

When a nursing home spouse is applying for Medicaid, the couple will need to complete a resource assessment tool based upon the resources (assets) owned at the snapshot date. The attorneys at Lockwood Legal assist our client’s through every part of the Medicaid application process.

Applicants are also required to fill out an application for Medicaid which asks for information about current resources at the time of application.

The community spouse’s share of the couple’s assets is calculated from the resource assessment tool. The nursing home spouse’s eligibility is determined from the application.

Assets of a married couple are generally considered to be jointly-owned no matter in whose name they have been placed.

If by now you have a headache, you are not alone. The Medicaid system is tragically and unnecessarily complex.

How Much Of The Couple’s Assets Can A Community Spouse Keep?

The community spouse is allowed to keep a maximum of half (1/2) of the non-exempt assets up to a total of $126,420 (1/2019) or at least a minimum of $25,284 (1/2019). These amounts increase annually.

The nursing home spouse is allowed only $3,000 in non-exempt assets to be eligible for Medicaid.

What Income Can Be Kept By Either Spouse?

The community spouse is allowed to keep all income that is solely in his/her name, plus half (1/2) of all jointly owned income. If his/her income does not equal as least $2,058 per month (7/2018), he/she may keep some of the nursing home spouse’s income to get up to the minimum level of $2,058.

If the community spouse has high living expenses, he/she may appeal to Medicaid to keep more of the nursing home spouse’s income – bringing his/her total minimum monthly income up to $3,161 (1/2019).

The nursing home spouse must contribute all of his/her income towards the cost of the nursing home except for $52 per month for personal needs and any dollar amounts for health insurance, premiums, taxes and medical expenses not covered by Medicaid. This contribution of income towards his/her care is called his/her “liability.”

Applying for Medicaid is an overly complex process requiring the skills of a qualified and experienced attorney. Whether you hire me or not, remember, employees working at the Medicaid office DO NOT represent you! As a former Assistant Attorney General who represented the state Medicaid agency itself, I have the experience and knowledge to fight to get you or your loved one enrolled in Medicaid.

Call Attorney Jim Lockwood 574-303-9005 for a free consultation regarding your case or E-Mail Jim.

Information provided on this site is for informational purposes only and does not constitute legal advice.

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