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For purposes of determining eligibility for Medicaid, a married couple is considered one economic unit (a similar concept to filing a joint federal income tax return). As such, it does not matter for the resource test in whose name an asset is titled.[i] In order to cause the non-institutionalized spouse (i.e., the spouse not needing nursing care) to have to become “poor” in order for the spouse needing long-term care to qualify for Medicaid, Congress enacted the Community Spouse Resource Allowance (“CSRA”).[ii] The subsection of the federal statute that governs the CSRA is titled “Protecting income for community spouse.”
First off, the CSRA only applies to the resource test and not to the income test when determining Medicaid eligibility. As such, the non-institutionalized spouse is able to retain all the non-countable (or exempt) resources such as the home, a care, household goods and personal effects. For purposes of the income test, the general rule is that whoever’s name is on the check will have that income counted against the income threshold (the 2021 amount is $2,382.00) for purposes of determining Medicaid.
When to determine countable resources? The Medicaid program uses a “snapshot” date; the date on which an assessment is made as to total resources of the married couple. The statute defines the snapshot date as the beginning of the first continuous period of institutionalization of the institutionalized spouse. What does that mean? Thankfully, from a practical standpoint, the county boards of social services use the first day of the month that the institutionalized spouse enters the nursing home or assisted living facility.
For 2021, the maximum CSRA in Florida is $130,380.00. This means that absent further planning, the well spouse can retain $130,380.00 of non-exempt assets. Importantly, Florida considers retirement accounts where the owner is required to take their required minimum distribution as an exempt asset (the distribution is income for purposes of the income test; See “Miller Trust”).
In addition, there is a minimum monthly maintenance needs allowance (“MMMNA”). The MMMNA may entitle the community spouse to retain a certain amount of the institutionalized spouse’s income in order to satisfy their monthly bills; this is not a state funded amount (again, from a policy perspective, not to impoverish another person and put more pressure on “the system”). For 2021, the minimum MMMNA is $2,178.00 and the maximum is $3,260.00.
Please contact our office to learn more about the CSRA.
[i] 42 USC § 1396r-5(c)(2)
[ii] See Medicare Catastrophic Coverage Act of 1988.