Medicaid Protections for Spouses

Brooklyn medicaid lawyers help families navigate complex medicaid laws.Spouses with partners that receive Medicaid long-term care benefits are entitled to retain some assets and income, even though the spouse is getting those benefits. Though laws vary by state, these “spousal protections” generally allow the spouse to maintain enough to live on.

This begins when an ill spouse that requires long-term care moves into a long-term care facility or hospital for a minimum of 30 days. To determine Medicaid long-term care eligibility, only the income for the ill spouse is used. Therefore, if the married spouse is working, they will not need to contribute to the cost of the long-term care. Some states do have income restrictions for this, though.

How Spousal Protections Work

To qualify for Medicaid benefits, the long-term care facility resident cannot have over $2,000 in assets (this amount varies by state). To determine benefits, the assets of both spouses are totaled. Married spouses can retain all of their personal income and may be able to claim part of the ill spouse’s income if needed.

The minimum monthly maintenance needs allowance (MMNA) are monies determined by Medicaid that help maintain an income level for the married spouse. This is determined when most of the couple’s income and assets are in the ill spouse’s name, and the married spouse does not have enough personal income to live on. The married spouse may be entitled to the ill spouse’s income in these situations. According to 2019 figures, MMNA can range from $2,000 to a little over $3,000 per month. Married spouses may qualify for MMNA increases by getting a court order for spousal support or contacting Medicaid.

Other Assets

The married spouse may keep half of the couple’s assets, the amount of which is set by state Medicaid agencies. As of 2019, this ranges from $74,820 to $126,420 in New York State. The Medicaid recipient’s house and property are also protected by Federal Medicaid laws, with certain limitations. Generally, if the ill spouse wishes to return home at some point, the first $585,000 in equity is not considered to be a resource for Medicaid eligibility. This also varies by state.

It is also possible to transfer the ill spouse’s assets to the married spouse, Medicaid does not enact penalties for doing so. The ill spouse can qualify for Medicaid if the assets are less than $15,150. There are guidelines that apply to the married spouses’ assets, though, and if they are higher than a certain amount that spouse may have to contribute to the long-term care costs.

Keeping Medicaid Income and Spousal Refusal

When Medicaid pays for the ill spouse’s long-term care, the other spouse does not have to use their income to contribute toward the cost. Married spouses may also be able to keep part of the ill spouse’s income. The amount is determined by Medicaid and is based on the married spouse’s personal income and any housing costs.

New York laws permits “spousal refusal,” meaning that the married spouse may decline to pay for the long-term care. In these situations, Medicaid may still have to pay for the services but will try to recover some of the costs by billing the married spouse. This may be a viable option for some married spouses.

Brooklyn Medicaid Lawyers at Korsinsky & Klein, LLP Help Families Navigate Complex Medicaid Laws

If you have questions about Medicaid eligibility or another estate planning concern, contact the experienced Brooklyn Medicaid lawyers at Korsinsky & Klein, LLP today to arrange a consultation. Call 212-495-8133 or contact us online to get started. We assist clients in Manhattan, Long Island, and Westchester, New York from our offices in Brooklyn, New York, and Lakewood, New Jersey.