In past issues of the Elder Law Today, we have explained how the Medicaid laws work for married couples when one spouse needs nursing home care. The Spousal Impoverishment Provisions make it clear that the Medicaid program does not intend to impoverish one spouse because the other requires nursing home care. Much of this is based on the spend down of assets and what asset levels must be met before the nursing home spouse qualifies.
The law states that for a married couple, the at-home spouse is entitled to keep a minimum amount of money with no spend down. The minimal spousal share effective January 1, 2017 is $24,180.00. In addition, the nursing home spouse may keep $2,000.00. In other words, for a married couple with $26,180 (plus $2,000 for the nursing home spouse), there will be no spend down.
The maximum amount the at-home spouse may keep for 2017 is one-half of their countable assets, but no more $120,900.00. This means that if a married couple has $241,800 or more in countable assets, the at-home spouse will be able to keep $120,900.
The Medicaid laws also allow for a Minimum Monthly Maintenance Needs Allowance. This is the minimum amount of income that the at-home spouse is allowed to keep. For 2017, the Minimum Monthly Maintenance Needs Allowance is $2,003.
There is also a Maximum Monthly Maintenance Needs Allowance. This is the amount of income the community spouse is allowed to keep if his or her home related expenses are high enough. For 2017, the Maximum Monthly Maintenance Needs Allowance for the community spouse is $3,023.
For any gifts made within the 5 year look back period, the Medicaid rules require a penalty be applied based upon the total value of all gifts. For 2017, the penalty divisor has surprisingly decreased to $8,018. As an example of how this would apply, assume Betsy Smith gives a total of $15,000 to her church over a 5 year period. If Ms. Smith later applies for Medicaid benefits to pay for her nursing home care, she would be penalized from receiving Medicaid benefits for 1.87 months ($15,000/8,018 = 1.87).