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Medicaid Changes May Mean More for Spouses

DownloadAllowing the spouse of a person in a nursing home to keep enough money to live on independently is, in many ways, a moral issue. But in a tight budget year in Connecticut, it's a fiscal issue. A proposal that would increase the minimum assets that a spouse living in the community can keep — from $23,844 to $50,000 — in order for his or her partner to be eligible for Medicaid nursing-home care is being backed by elder advocates, who say the increase would help seniors, especially women, remain able to live independently. But the move is being opposed by the Department of Social Services on the grounds it will shift millions in costs to the state-funded Medicaid program.

The CT Post report, in an article titled “Legislature asked to raise asset level for Medicaid spouses,”says that the bill would affect couples with assets of about $24,000 to $100,000. Right now, when a person tries to qualify for Medicaid, couples will split their assets evenly, and the nursing-home-bound spouse must spend down his or her portion to $1,600. This means if a couple has $60,000, each spouse is attributed $30,000, and the one heading to the care facility must get his or her share down to $1,600. [Note: These numbers can and do vary state by state.] This is typically accomplished by paying for initial nursing home care. Under the state’s new proposal, the community spouse would be able to keep $50,000 in assets.

If this legislation succeeds in reducing the amount of money assigned to the institutionalized spouse, he or she would become eligible for Medicaid assistance more quickly. The original article says that advocates believe that in allowing the community spouse to keep $50,000, it might help him or her stay out of poverty, off government programs, and in the couple's home.

Raising the allowance for spouses could save money in the long run: it could keep the spouses off public assistance longer by giving them some money for health or other emergencies that could impoverish them.

In all states, federal Medicaid law provides special protections for the spouses of Medicaid applicants. However, it’s the states that determine the amount of money the non-institutionalized spouse may keep (within a range). Connecticut's allowance of $23,844 is the lowest in the country. States like Massachusetts, Vermont, Maine and Illinois are much higher. The highest is reported to be $119,200.

Medicaid nursing home costs average an estimated $6,000 a month in the state, so it can be quite an expense. See how your state is handling the Medicaid spend-down, and if there are any changes on the horizon. Make an appointment to see a qualified elder law attorney to discuss Medicaid in your state.

Reference: CT Post (March 10, 2015) “Legislature asked to raise asset level for Medicaid spouses”

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