Medicaid: Eligibility: Spousal Impoverishment Rules With Respect To Nursing Homes
If one member of a married couple goes into a nursing home, the other spouse (known in Medicaid speak as the "community spouse") does not have to become broke and homeless before the patient can qualify for Medicaid. Spousal impoverishment rules come into play when one spouse enters a nursing home and is expected to be there for at least 30 days.
- The community spouse is allowed to keep up to 50% of the non-exempt assets, subject to a minimum and a maximum. The minimum and maximum change from year to year. To learn about the current year's rules, see: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Spousal-Impoverishment-Page.html
- States may raise the minimums to any level up to the federal maximum. The amounts are also adjusted annually for inflation. To determine the situation in your state, see http://covertheuninsured.org/stateguides/.
In all circumstances, the income of the community spouse continues undisturbed. The spouse does not have to use his or her income to support the nursing home spouse receiving Medicaid benefits. If the couple's income is in the name of the institutionalized spouse, and the community spouse's income is not enough to live on, the community spouse is entitled to some or all of the monthly income of the institutionalized spouse. To learn more, see: Medicaid: Custodial Care: Permitted Spousal Income Modifications.
After a spouse is in an institutionalized setting, a post-eligibility process is used to determine how much the spouse in the medical community must contribute toward his or her cost of the care. The process also determines how much of the income of the spouse who is in the medical facility is actually protected for use by the community spouse.
The process starts by determining the total income of the spouse in the medical facility. From that spouse's total income, deductions are permitted.
To learn about the current year's rules, see: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Spousal-Impoverishment-Page.html
NOTE: These rules are in addition to the rules that apply to the general Medicaid rules about property that doesn't get counted as an asset for eligibility purposes ("exempt property") such as the value of a patient's home and a vehicle.