Protecting Spouses of Medicaid Applicants: 2023 Guidelines

The Centers for Medicare & Medicaid Services (CMS) has released the 2023 federal guidelines for how much money the spouses of institutionalized Medicaid recipients may keep, as well as related Medicaid figures.

What Are Spousal Impoverishment Rules?

Spousal impoverishment is a concern for older 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 (the spouse at home is 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.

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, Michigan allows a community spouse to receive income of at least $29,724 per year. If the income of the community spouse is not high enough to reach that threshhold, the medicaid rules allow the spouse in the nursing home to transfer income to the community spouse each month. In some instances, the community spouse may keep additional income based on the costs of their mortgage and costs of maintaining the home.

Monthly Maintenance Needs Allowance

Meanwhile, the maximum monthly maintenance needs allowance (MMMNA) for 2023 will be $3,715.50. This is the most in monthly income that a community spouse is allowed to have if their own income is not enough to live on and they must take some or all of the institutionalized spouse’s income.

The minimum monthly maintenance needs allowance for the lower 48 states will be $2,288.75 ($2,861.25 for Alaska and $2,632.50 for Hawaii) until July 1, 2023.

In determining how much income a particular community spouse is allowed to retain, states must abide by this upper and lower range. Bear in mind that these figures apply only if the community spouse needs to take income from the institutionalized spouse.

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

Learn more about the CSRA and monthly maintenance needs allowance.

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. Although it is definitely an advantage for the medicaid recipient or spouse to keep the residence as a non-counted asset, it is also important to have a plan for how the home will be maintained. That is especially true in the case of a single person, where most of their income will beneeded to pay for their cost of care and they will not have additional funds to pay for taxes, insurance, utilities and mainenance. 

The complex Medicaid rules require experience and planning to navigate properly. At Wenzel Bennett & Harris, our attorneys and staff have many years of experience in helping individuals and families successfully plan to manage their assets and qualify for medicaid benefits. Call our office at (989) 356-6128 to schedule a Long Term Care Consult. 

Our experienced team will work with you to develop a strategy that meets your needs and the needs of your family.

If you have specific questions about your situation or would like to learn more, reach out to the team at WBH here.

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