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When seeking Medicaid benefits, married couples have a lot to consider. Besides making sure they meet the eligibility requirements, you must also address the specific, and potentially uncommon, details of their case. For instance, you want to make sure you know about any previous care the institutionalized individual received, especially if it resulted in 30 days of continuous institutionalization. This may affect their snapshot date and, as a result, the Community Spouse Resource Allowance.
Read More: When Does the Medicaid Penalty Period Begin?
What is the Community Spouse Resource Allowance?
One concern many couples face when applying for Medicaid is the wellbeing of the community spouse. Fortunately, Medicaid has adopted certain measures to prevent spousal impoverishment and ensure the spouse at home can maintain their current lifestyle in the community. One of these measures is the Community Spouse Resource Allowance (CSRA), which pertains to the amount of assets the community spouse can retain while qualifying the institutionalized spouse for Medicaid benefits. This allowance varies by state but is generally between $26,076 and $130,380 in 2021. Some states have a standard CSRA, which represents the standard amount the community spouse can keep, while others have a minimum and maximum allowance.
Do You Live in a Standard or Min/Max CSRA State? View Your State Resources
What is the Snapshot Date?
In states with a minimum and maximum CSRA, the amount the community spouse can keep depends on their snapshot date. According to 42 U.S.C. § 1396r–5, the snapshot date is the first date of the first continuous period of institutionalization for the Medicaid applicant. More specifically, continuous institutionalization is defined as 30 consecutive days in a care institution, which includes a hospital, nursing home, VA facility, or a combination of these.
To determine the community spouse’s allowance, the state Medicaid agency will review the couple’s finances as of the snapshot date and divide that amount in half. The community spouse is entitled to keep half of the couple’s total countable assets as of that date, not to exceed the maximum CSRA and not to fall below the minimum CSRA.
- If the resulting figure is less than the minimum CSRA, the community spouse may keep the minimum CSRA.
- If the resulting figure is between the minimum and maximum CSRA, the community spouse may keep that amount.
- If the resulting figure exceeds the maximum CSRA, the community spouse may keep the maximum CSRA.
Watch Now: What is the CSRA? [Attorney Access Required]
Consider Prior Institutionalization
Since the snapshot date pertains to the first date of the individual’s first 30-day period of continuous institutionalization, make sure you understand the full scope of your client’s situation. If the institutionalized spouse previously spent 30 consecutive days receiving care, whether in a hospital, nursing home, or other skilled nursing facility, the state Medicaid agency will use that care event to determine the snapshot date. In many of these cases, the individual likely recovered from that event and lived normally until the health event that required them to receive care now.
As you can imagine, an earlier snapshot date may be beneficial for your client, especially if they are a lot older now and have spent down a majority of their savings. In these cases, their countable assets as of the earlier snapshot date were likely higher than the recent date of institutionalization, which means the community spouse can retain a larger allowance. However, it’s important to consider other scenarios. For instance, the couple may have received an inheritance, sold their home, or grew their wealth in some other way between the first institutionalization and now. In these cases, their countable assets may be higher now than the first date of the earlier institutionalization. Unfortunately, the state Medicaid agency will still use their finances as of that first institutionalization to determine the community spouse’s allowance.
When developing a Medicaid plan for your client, make sure you consider these factors and ensure you have all the relevant information for your client’s case. You want to set clear expectations for all economic benefits of the plan, including the Community Spouse Resource Allowance. That’s why it’s crucial to understand the snapshot date. If you have questions about a specific crisis planning case, don’t hesitate to reach out to our team at Krause Financial.
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