Medicaid’s Spousal Impoverishment Protections

2023 Guide to Medicaid’s Spousal Impoverishment Protections

The federal guidelines for the amount of money spouses of institutionalized Medicaid recipients can retain in 2023 have been announced by the Centers for Medicare & Medicaid Services (CMS).

Fears and rumors about Medicaid long-term care run rampant, and many people worry that if their spouse receives long-term care, the government will take the couple’s last dime before offering Medicaid benefits. Thankfully, that’s far from true.

Medicaid Terminology for Spouses

Medicaid uses specific language when referring to a couple where one spouse receives long-term care and the other does not:

  • Institutionalized Spouse: the spouse who is receiving long-term care in a nursing home
  • Community Spouse: the spouse who lives outside a nursing home and does not require long-term care

What is Spousal Impoverishment and What Are Its Rules?

Before the federal government enacted “spousal impoverishment” protections in the 1980s, many healthy spouses faced poverty when their partners needed long-term care in a nursing home. The steep expense of nursing-home level care wiped out a couple’s savings before the institutionalized spouse received Medicaid benefits. Community spouses were left with little or no income or resources.

Medicaid’s CSRA

Each year, the federal government adjusts the Medicaid Community Spouse Resource Allowance (CSRA), which is the portion of the couple’s income and resources protected for the community spouse. In 2023, the community spouse of a Virginia Medicaid recipient living in a nursing home may keep as much as $148,620 without jeopardizing the Medicaid eligibility of the institutionalized spouse. The minimum CSRA a community spouse will retain in 2023 is $29,724.

Medicaid’s MMMNA 

Community spouses are also permitted to keep a certain amount of the institutionalized spouse’s income if their own income is not enough on which to live. The Minimum Monthly Maintenance Needs Allowance (MMMNA) is $2,288.75 until July 1, 2023. A value that takes into consideration need-based factors such as mortgage, utilities, and other expenses, the maximum monthly maintenance needs allowance for a community spouse is $3,715.50 in 2023.

Community spouses who bring in more income than their institutionalized counterpart may keep all of their own income, even if it exceeds the maximum monthly maintenance needs allowance.

A Recognized Name in Richmond Elder Law & Estate Planning

If you are considering whether Medicaid is the best way for you and your spouse to afford long-term care expenses, contact us to discuss your options with one of our experienced attorneys.