How Will Your Income be Affected If Your Spouse is in a Nursing Facility Receiving Medicaid Benefits?

Once your spouse has been approved for Medicaid to help pay the nursing home expense, you may wonder what will happen to your income. As the non-Medicaid-recipient spouse (“community spouse”) who is residing at home or with relatives, in an apartment or condominium, or in assisted living, you may be eligible to receive a portion of your spouse’s income each month.

According to The Indiana Long Term Care Partnership Program page on the Indiana Medicaid website (http://www.in.gov/iltcp/2340.htm), the Spousal Impoverishment Protection Law applies for nursing home admissions occurring on or after September 30, 1989. Protection under the law applies to nursing home, in-home and community type care services under the Medicaid Aged and Disabled Waiver. The purpose of the law is to allow the community spouse to keep some of the couple’s income and assets while still qualifying the nursing home spouse for Medicaid.

As the community spouse, you may keep all income that is solely in your name, and one-half of the joint income with your spouse. The minimum income for you, as the community spouse, is $2,002.00 (effective July, 2016). If your income as the community spouse is less than this amount, then you may be eligible to receive a portion of your Medicaid-recipient spouse’s income each month. During the Medicaid interview process, the caseworker will request verification of mortgage or rent, utility costs, homeowner’s insurance premiums, and property taxes. Based on these expenses, it may be possible to increase your “spousal allocation” to a maximum of $2,980.00 (effective January, 2016). An appeal may need to be filed in order to increase the allocation.

Your institutionalized spouse will be responsible for paying his or her “liability” to the nursing home, once Medicaid is approved. This amount is calculated by Medicaid during the application process. The gross income of your institutionalized spouse is reduced by any health insurance premiums that he or she pays each month, a $52.00 Personal Needs Allowance (an allowance for haircuts, snacks, and other miscellaneous items that your spouse may need each month), and the spousal allocation that is paid to you. The remaining income will be known as the liability amount, and should be paid to the nursing home each month.

If you or your spouse are currently privately paying in a nursing facility and have questions about how to potentially protect your income and assets, please contact my office at (812) 423‑1500 to schedule a consultation.