Medicaid Allowances for the Healthy Spouse

While Medicaid is not a concern for everyone, it can be extremely relevant to people who need to qualify for Medicaid because Medicare will not pay for custodial care. Custodial care is the type of assistance you would receive in a nursing home or in some assisted living communities.

Actually, everyone should take Medicaid seriously, because 70 percent of senior citizens will eventually need help with their activities of daily living. Many folks who need this assistance can get the help they need from family members and friends so long as they are still capable of doing a lot of things on their own.

At some point, however, professional assistance may be the only option.

Long-Term Care Costs

Long term care is expensive and it can be tough to pay these expenses if you have been living on your retirement income and savings for a number of years.

According to the state, the average cost for a day in a nursing home in Oklahoma is $178, and in Kansas the cost is $220. These are very conservative estimates, because many facilities come with significantly higher price tags.  In 2019 the cost of care was actually closer to $7,000 per month.

Assisted living communities and in-home caregivers are also expensive, meaning a lot of people would go broke if they had to pay these bills. They would be giving up their peace of mind and giving their children’s inheritances to these facilities.

Medicaid Rules for Healthy Spouses

Fortunately, Medicaid exists to fill the gap, and the majority of elders in nursing homes are Medicaid beneficiaries. But not everyone qualifies.  Because this is a needs-based program, you are only allowed to have $2,000 in assets, including our IRAs.

Some things are exempt and do not count against this $2,000 cap, but we will get into them in another post.  Right now, we want to focus on the rules for healthy spouses.

If you apply for Medicaid to pay for your stay a nursing home and your spouse is still capable of independent living, your spouse would receive a “Community Spouse Resource Allowance” (CSRA) equal to half of your shared countable assets–but there’s a limit.

We have offices in Oklahoma and Kansas and in both states, the maximum CSRA is $128,640. There is also a minimum allowance of $25,284, so a healthy spouse can keep at least this amount even if it is more than half of the shared assets.

When a nursing home resident qualifies for Medicaid, with the exception of a small personal needs allowance of $75, all the resident’s income goes toward the cost of the care being provided.

This requirement may be waived in full or in part if the healthy spouse is relying on all or some of this income.  The community spouse is entitled to a Monthly Maintenance Needs Allowance which, in Oklahoma and Kansas, is a the maximum of $3,216.

Access Our Free Worksheet!

We have a number of useful resources you can access right here on our site.  One of them is our peace of mind worksheet. You can learn a lot if you take the time to go through it, and it is offered free of charge.

To get your copy, visit our worksheet access page and follow the simple instructions.

Need Help Now?

If you are ready to work with an attorney to develop a comprehensive plan for the future, we are here to help. In light of the dangers presented by the coronavirus, we are offering remote consultations, so you can get the help you need without taking any risks.

You can set up an appointment at our Oklahoma City office by calling 405-843-6100, or at our Overland Park office by calling 913-385-9400. There is also a contact form on this site you can use to send us a message.