Applying for Medicaid when you have a spouse at home
Published 6:45 pm, Wednesday, September 7, 2011
Although the goal for most families today is to keep loved ones at home while they are receiving care, it is often the case an illness will progress to the point too much care is required and placement in a nursing home becomes necessary.
In the case of married couples, it is rare for both spouses to require nursing home care at the same time.
More often than not, home care becomes too much for the healthy spouse, and the ill spouse must begin to receive care in a nursing home.
The most common question that accompanies this very significant step of placing a spouse into a nursing home is, "What happens to our assets?"
Last year, a new law went into effect that allowed the "community spouse" to keep all of the assets, up to $109,560.
The following were not counted toward the $109,560: the home, as long as the community spouse was living in it; one car of any value; all personal belongings; and a prepaid funeral contract.
The "institutionalized spouse," or the spouse receiving long-term care in a nursing home, could keep only $1,600 in assets, in addition to personal belongings and a prepaid funeral contract.
The change in the law during 2010 was great news for a community spouse because it was a change that allowed the CSPA ("community spouse protected mount") to be greater than it had been in years past.
This year, effective July 1, the new law was repealed and the old law is back in effect.
Now, a community spouse can keep only one-half of the assets, up to $109,560, and the same exempt items that were mentioned above.
When a married individual applies for Medicaid, the Department of Social Services looks at all assets, regardless of whether they are titled in the name of one spouse or the other, or both spouses.
For example, if a married couple has a total amount of assets of $300,000, the community spouse can keep one-half of that amount, not to exceed $109,560.
In this example, the community spouse keeps the full $109,560 and the institutionalized spouse keeps $1,600.
The rest must be spent on anything for fair market value (i.e., anything that can be proven with a receipt or an invoice; no gifting). As a different example, if a married couple has a total of $150,000 in assets, the community spouse can keep only one-half of that amount, which is $75,000.
The institutionalized spouse still keeps only $1,600.
Under the rule that was in effect from July 1, 2010 through June 30, 2011, that same community spouse would have been able to keep $109,560 instead of the $75,000 that he/she is now allowed.
The total amount of assets for the married couple is determined after 30 days of continuous care and is based upon the couple's assets on the first date the institutionalized spouse was considered to be "institutionalized" whether in a hospital, nursing home or at home.
In order to be sure the amount being spent down for Medicaid purposes is correct, and is not done too soon, it is always a good idea to consult with an elder law attorney.
It is also important to make sure the appropriate forms to calculate the CSPA are completed, and you are aware of any new changes to the law.
Rudolf Kuss and Michelle M. Liguori are partners at the law firm of Kuss & Liguori LLC in New Milford. Both are admitted to the practice of law in Connecticut and are members of the Connecticut Bar Association and the New Milford Bar Association.