Disclaimer: With Medicaid, VA, and insurance regulations frequently changing, past blog posts may not be presently accurate or relevant. Please contact our office for information on current planning strategies, tips, and how-to's.
When developing a long-term care plan and seeking Medicaid benefits for your client, it’s important to address all the details of their case, from ensuring they meet the eligibility requirements to making note of any prior instances of institutionalization. Has the institutionalized individual received 30 consecutive days of care at an earlier date? This is especially important when working with married couples since a previous long-term care stay may affect their Medicaid snapshot date and, as a result, the Community Spouse Resource Allowance.
What is the Community Spouse Resource Allowance?
A concern that many couples have when applying for Medicaid is safeguarding the wellbeing of the healthy spouse. In order to prevent spousal impoverishment, Medicaid has adopted certain measures to ensure the community spouse can maintain their current lifestyle in the community while still qualifying the institutionalized spouse for benefits. One of these measures is the Community Spouse Resource Allowance (CSRA), which refers to the amount of countable assets the community spouse can keep.
Although the institutionalized spouse can only retain $2,000 in most states, the community spouse is able to keep a much larger amount. The CSRA varies by state but is generally between $26,076 and $130,380 in 2021. Some states have a standard CSRA, which signifies the standard amount a community spouse can keep, while other states have a minimum and maximum allowance.
Do You Live in a Standard or Min/Max CSRA State? View Your State Resources
What is the Snapshot Date?
If your client lives in a state with a minimum and maximum allowance, their CSRA is calculated based on the snapshot date. According to 42 U.S.C. § 1396r–5, the snapshot date is the first date of the first continuous period of institutionalization for the Medicaid applicant. Continuous institutionalization is defined as 30 consecutive days in a care institution, which includes a hospital, nursing home, VA facility, or a combination of these.
To determine the community spouse’s allowance, the state Medicaid agency looks at the couple’s total finances as of the snapshot date and divides that amount in half. The community spouse is entitled to keep half of the couple’s total countable assets as of that date, not to exceed the maximum CSRA and not to fall below the minimum CSRA.
- If the resulting amount is less than the minimum CSRA, the community spouse may keep the minimum CSRA.
- If the resulting amount is between the minimum and maximum CSRA, the community spouse may keep that amount.
- If the resulting amount exceeds the maximum CSRA, the community spouse may keep the maximum CSRA.
How Can Prior Institutionalization Affect the Snapshot Date?
If your client, the institutionalized spouse, previously spent 30 consecutive days receiving care, whether in a hospital, nursing home, or a combination of facilities, the state Medicaid agency will use the first day of that care event to determine the snapshot date. Therefore, it’s important that you understand the full scope of your client’s situation. In many of these cases, the individual likely recovered and lived normally until the health event that resulted in their current long-term care need. Some couples may forget to disclose this information.
As you can imagine, an earlier snapshot date may be beneficial for your client, especially if they have spent down a majority of their savings since the initial care need. In these cases, their total countable assets as of the earlier snapshot date were probably much higher than the recent date of institutionalization, which means the community spouse will be eligible to retain a larger allowance. However, it’s important to consider other scenarios. For example, the couple may have received an inheritance, sold their home, or increased their wealth in some other way between the first institutionalization and now. In these cases, their countable assets may be higher now than the first date of the earlier institutionalization. Unfortunately, the state Medicaid agency will still use that as their snapshot date to determine the community spouse’s allowance.
When developing a Medicaid plan for your client, make sure you consider these factors and make sure you have all the relevant information for your client’s case. You want to set clear expectations for the economic benefits of the plan, including the Community Spouse Resource Allowance. That’s why it’s crucial to understand the snapshot date and other Medicaid regulations. We always recommend working with an elder law attorney on crisis planning cases since they can provide their legal expertise and ensure all the bases are covered.
If you have questions about a specific case or are interested in learning more about Medicaid planning, don’t hesitate to reach out to our team at The Krause Agency.