Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Resource Protection

10/29/2010

The resource amount protected for the spouse is determined as part of the process of determining Medicaid eligibility of the person needing services. Countable resources belonging to either or both spouses are combined and divided in half. The amount protected for the spouse is either that half, or the level the state has chosen to protect, whichever is higher. In 2010, the amount protected is subject to a Federal minimum ($21,912) and maximum ($109,560).

Any resources not protected for the spouse are considered available to the person needing care, who is not eligible until such resources are within Medicaid eligibility limits.

Examples of Spousal Resource Protection

  • The non-Medicaid spouse in a couple with combined total assets of $21,912 or less is allowed to keep the entire amount and the institutional spouse meets the assets eligibility criterion without delay.

  • In a state using the Federal minimum level, couples with total countable assets of $100,000 will have $50,000 protected for the at-home spouse. The remaining $50,000 is attributed to the institutionalized spouse, making that person ineligible for Medicaid until $48,000 is spent (assuming the applicable Medicaid resource eligibility level is the typical $2,000).

  • In a state electing a higher minimum protected amount of, say, $75,000, couples with combined countable assets of $100,000 will have $75,000 protected for the non-Medicaid spouse. The remaining $25,000 is attributed to the institutionalized spouse, making that person ineligible until $23,000 is spent (again assuming the typical $2,000 as the applicable Medicaid resource eligibility level).

  • In a state protecting the highest amount allowed ($109,560), a spouse in a couple with total assets of $100,000 would keep the entire amount.

Minimum and maximum amounts of both income and resources increase every year based on the cost-of-living increase as published by the Department of Health and Human Services. In addition, Federal law requires states to have administrative and judicial procedures in place that allow petitioners to seek higher protected amounts of the spouse’s assets. For example, spouses can petition for higher protected assets if the income those assets produce is needed for their reasonable living expenses.

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