Jan Neal Law Firm, LLC

Alabama Estate, Elder and Special Needs Law

2023 Guidelines for Protecting Spouses of Medicaid Applicants

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The Centers for Medicare & Medicaid Services (CMS) has released the 2023 federal guidelines for how much money the spouse of an institutionalized Medicaid recipient may keep to protect himself or herself when a spouse enters a nursing home and qualifies for Medicaid.

What Are Spousal Impoverishment Rules?

Spousal impoverishment is a concern for couples when there is one spouse who requires long-term care and applies for Medicaid. Before the federal government enacted spousal impoverishment protections, many healthy spouses faced poverty when their partners needed long-term care. The spousal impoverishment rules are based on the idea that spouses will provide for each other.

Community Spouse Resource Allowance

In 2023, the spouse of a Medicaid recipient living in a nursing home who is living at home (called the “community spouse”) may keep as much as $148,620 without jeopardizing the Medicaid eligibility of the spouse who is receiving long-term care. That is an increase from 2022’s cap at $137,400.

Known as the community spouse resource allowance (CSRA), this is the most that a state may allow a community spouse to retain without a hearing or a court order. While some states set a lower maximum, the least that a state may allow a community spouse to retain in 2023 will be $29,724. That amount is up from 2022’s $27,480.

Monthly Maintenance Needs Allowance

Meanwhile, the maximum monthly maintenance needs allowance (MMMNA) for 2023 will be $3,715.50 (up from $$2289 in 2022). This is the amount of monthly income that a community spouse can bring his or her income up to by routing some of the institutionalize spouse’s income home for the use of the community spouse. That number will not go into effect until July 1, 2023.

According to Medicaid law, the community spouse may keep all their own income, even if it exceeds the maximum monthly maintenance needs allowance.

The new spousal impoverishment numbers (except for the minimum monthly maintenance needs allowance) take effect on January 1, 2023.

Home Equity Limits

In 2023, a Medicaid applicant’s principal residence will not be counted as an asset by Medicaid if the applicant’s equity interest in the home is less than $688,000. States have the option of raising this limit to $1,033,000. In 2022 that maximum equity interest limit is $955,000.

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