Currently, there are 31 states* where Medicaid treats a community spouse’s IRA account as a countable resource. Thus, before an institutionalized spouse can qualify for Medicaid benefits, the community spouse’s IRA account must be either protected or spent-down.

Protecting the Community Spouse’s IRA

The best way to protect the community spouse’s IRA account is to make it part of his or her community spouse resource allowance (CSRA). In 2015, with the maximum CSRA being $119,220, if a couple had total countable resources of $275,000 ($175,000 of which was in the community spouse’s IRA account) the community spouse would be advised to leave $119,220 in the IRA account. As for the balance of $55,780, the community spouse would further be advised to invest the amount into a tax-qualified DRA compliant immediate annuity (Tax-Qualified Annuity, or TQA).

Taxation and the Community Spouse’s IRA

The $119,220 remaining in community spouse’s IRA account would not be subject to income taxation. As for the funding of the TQA – which was accomplished by an IRA Direct Transfer (preferred method) or a 60-day IRA Rollover** – the funding transaction would not be subject to income taxation. However, as the community spouse receives the monthly payments from the TQA, he or she would be taxed on the payments received in the given year.

Eliminating the Remaining Spend-Down

As for the remaining spend-down of $100,000, the community spouse would be advised to invest the amount into a DRA compliant immediate annuity (DCIA). Since a DCIA involves after-tax dollars, unlike the TQA, which involves pre-tax dollars, only a small portion of each payment is subject to income taxation in the year of receipt.

One Annuity Versus Two Annuities

For purposes of simplicity, some clients have requested to use only one annuity rather than the two detailed above. However, because the Internal Revenue Code does not allow qualified funds (pre-tax) to be mixed with non-qualified funds (post-tax), two annuity contracts are required.

Conclusion

At the Krause Agency, we understand that Medicaid planning with IRAs is complicated. However, between our unique annuity product line and vast state-specific Medicaid knowledge, we are more than equipped to handle your most challenging cases. So, if you have a case involving a countable IRA, please do not hesitate to get in touch with us.

* This applies to the following states:  Alabama, Arizona, Arkansas, Colorado, Connecticut, Hawaii, Illinois, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Dakota, Texas, Utah, Virginia, and Washington. Additionally, Texas’ Medicaid rules sometimes allow for the use of a tax-deferred annuity rather than an immediate annuity.

** Pursuant to Bobrow v. Commissioner the IRS has announced that they will apply the Bobrow interpretation of § 408(d)(3)(B) to any rollover that involves an IRA distribution after January 1, 2015. Please consult with a tax expert for specific advice.