Attorney for Spousal Impoverishment Rules in Louisiana

What Is Spousal Impoverishment?

When a couple is married, and one spouse applies to receive Medicaid long-term care benefits, there are rules that address "spousal impoverishment." These rules are meant to ensure that the spouse who did not apply for benefits will have sufficient income and financial resources that may be used to meet their ongoing needs. Medicaid is meant to provide benefits for those who have limited income and financial resources. Spousal impoverishment rules can ensure that when one spouse lives in a nursing home or assisted living facility, this will not result in the other spouse struggling to meet their financial needs. The healthier spouse still living at home (or in the "community") is referred to in Medicaid vernacular as the "Community Spouse." Some time ago, Congress determined that it was good policy to develop rules that resulted in avoiding impoverishment of the Community Spouse. One such protection involved allowing an increased amount that is protected by law as a non-countable resource when determining Medicaid eligibility for the spouse who needs long-term care. The additional protected amount is called the "Community Resource Allowance" (CSRA). The CSRA is the total amount of countable resources also protected in addition to the Individual Countable Resource Allowance.

To be eligible for Medicaid, certain limits apply to the assets a person can own. In cases where Medicaid applicants are married, the couple's assets will be considered to be jointly owned by both spouses. Whether an asset is titled in the name of either or both spouses, it may be considered when determining the eligibility of the spouse applying for benefits. In general, a $2,000 asset limit will apply for a single person in benefits cases filed in 2023. However, Medicaid allows for a larger portion of the assets owed by a couple to be protected as the CSRA. In Louisiana in 2023, the CSRA for the Community Spouse is $148,620.

When addressing income earned by spouses, a rule known as the Minimum Monthly Maintenance Needs Allowance (MMMNA) will apply. A spouse who applies for Medicaid may transfer some of the income they receive to the non-applicant spouse. The MMMNA is more particularly discussed in this website under the section on Qualifications for Medicaid Long-Term Care Benefits.

States calculate the CSRA in different ways. Some states, the majority, use the one-half deduction approach in calculating the CSRA. The CSRA in such states ranges from a minimum CSRA of $29,724 to a maximum of $148,620 (as of 2023). Other states, like Louisiana, use a straight deduction using the maximum federal CSRA. Contact a Certified Medicaid Planner like Gary Brown to check the CSRA for your state.

Both methods of calculation use a defined particular date called the "snapshot date" to count the assets in determining Medicaid eligibility. The snapshot date is determined by the state Medicaid eligibility manual. As a general rule, the snapshot date is the first day of entry into a nursing home (in the circumstance where there is no hospital admission preceding the nursing home admission) where the stay lasts 30 consecutive days OR the date the patient first was admitted to the hospital for a hospital stay that immediately precedes a transfer to a nursing home.

As discussed previously, during the initial asset calculation (on the snapshot date) and the initial application for Medicaid, all assets are considered to be owned by the couple as a whole, regardless of who actually owns them or in whose name they are titled. Anything either spouse has any ownership interest in is fair game in determining the amount of resources of the Medicaid applicant.

Contact Our Orleans Parish Medicaid Planning Lawyer for Spousal Impoverishment

Contact Gary Brown to ensure that the Community Spouse Impoverishment rules are utilized to ensure that a spouse receives all the protections afforded to him or her by law. Call 504-447-6000 to schedule an initial consultation.