MCCA includes a mechanism for increasing both the CSRA and the MMMNA in certain cases. The methods by which this can be effected are described in 1396r-5(e), (d)(5) and (f)(3). Blumberg v. Tennessee Department of Human Resources, 2000 WL 1586454 (Tenn.Ct.App.) was a case where a Community Spouse sought a court adjustment of the default […]
As eligibility is being determined, if the Community Spouse’s monthly income falls below the Minimum Monthly Maintenance Needs Allowance (“MMMNA”), then MCCA contemplates two methods of raising her income up to the MMMNA. First, a portion of the Institutionalized Spouse’s income may be transferred to her to bring her income up to the MMMNA. Second, […]
Income and resources are treated differently. Unlike resources, income is not pooled in determining eligibility; the Community Spouse’s separate income is never considered available to the Institutionalized Spouse. Thus, the standard income eligibility process for one person applies. First, all income earned by the Community Spouse is always unavailable to pay nursing home bills, regardless […]
In Dullard v. Minnesota Department of Human Services, 529 N.W.2d 438, 443 (Minn. App. 1995), Minnesota was allowed to reevaluate eligibility after a couple moved from Illinois to Minnesota. There, Illinois (like Georgia) allowed the Community Spouse to keep the maximum CSRA, while Minnesota (like Tennessee) applied a formula resulting in a lower CSRA. The […]
Some couples might consider reducing the size of the marital estate by giving their resources away. Frequently this is the result when the plan is “home-made.” However, transfers for less than fair market value, including complete and partial gifts) trigger a period of ineligibility. 42 U.S.C. 1396p(c). It does not matter whether the applicant or […]
Federal law protects the healthy (or healthier) spouse of a nursing home resident. The healthier spouse is known in Medicaidland as the Community Spouse. The protections, known as the Spousal Impoverishment Rule (but logically be called the anti-impoverishment rule) were passed as part of the Medicare Catastrophic Coverage Act of 1988, P.ub. L. No. 100-360 […]
The following the committe report for the Medicare Catastrophic Coverage Act of 1988 (MCCA): The leading cause of financial catastrophe among the elderly is the need for long-term care, especially the need for nursing home placement. The expense of nursing home care–which can range from $2,000 to $3,000 per month or more–has the potential for […]
While nursing home bills accrue, the healthy or well spouse, known as the “Community Spouse,” [Note 1] struggles to identify and keep income and resources that are necessary to support herself. [Note 2]. To remedy this situation, Congress enacted spousal impoverishment provisions as part of the Medicare Catastrophic Coverage Act of 1988 (“MCCA”). [Note 3]. […]
If you agree to file a client’s Medicaid application as part of your representation, here are a few practical considerations. Keep in mind, these suggestions are how we handle matters in our office. If you have a different approach, that’s fine. If you have suggestions on other ways to approach applications, we’d love to hear […]
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