The Center for Medicare and Medicaid Services (CMS) has announced changes to the Long-term Care Spousal Standards that apply to a community spouse. A community spouse is a person who is not an inpatient in a medical institution or a nursing facility, but is married to a person who is an inpatient in a medical institution or a nursing facility (the institutionalized spouse). The standards that will change in 2008 include, but are not limited to, the Maximum and Minimum Spousal Resource Standards and the Maximum Monthly Maintenance Needs Allowance (MMMNA).
The Protected Resource Allowance (PRA) is the amount of assets that the community spouse is allowed to retain when the institutionalized spouse is eligible for Medicaid. The PRA is the greatest of either: 1) the Spousal Share (one-half of the total amount of joint countable assets as of the first day of continuous institutionalization for the institutionalized spouse), or 2) the Maximum Spousal Resource Standard at the time of application, or 3) the amount actually transferred to the community spouse as court-ordered spousal support, or 4) an amount determined at a hearing by the Department of Medical Assistance Services (DMAS). The PRA can be no more than the Maximum Spousal Resource Standard and no less than the Minimum Spousal Resource Standard. The Maximum and Minimum Spousal Resource Standards increase each year based on changes in the Consumer Price Index. On January 1, 2008, the Maximum Spousal Resource Standard will increase by $2,760 to $104,400. (The maximum for 2007 is $101,640.) The Minimum Spousal Resource Standard will increase by $552, from $20,328 in 2007 to $20,880 in 2008.
The Spousal Resource Standard is often called the Community Spouse Resource Allowance (CSRA), but technically this is incorrect. According to the Virginia Medicaid Manual, the CSRA is the amount of assets that can be transferred from the institutionalized spouse to the community spouse in order to bring the community spouse’s protected assets up to the PRA. For example, if the total joint countable assets are $150,000, (and there is no court-ordered spousal support or DMAS hearing amount), then the Spousal Share (and thus the PRA) is $75,000. If the community spouse has $50,000 in countable assets, and the institutionalized spouse has $100,000 in countable assets, then the amount that can be transferred from the institutionalized spouse to the community spouse (the CSRA) is $25,000.
The MMMNA has a minimum allowance amount and a maximum allowance amount. The MMMNA for 2007 is $1,711.25, and this amount will remain as the minimum allowance for the first half of 2008. The maximum maintenance needs allowance for 2008 will increase by $69.00, from $2,541.00 in 2007 to $2,610.00 in 2008. The community spouse excess Shelter Standard for 2007 is $513.38, and this amount will remain the same for the first half of 2008.
Andrew H. Hook
Oast & Hook
www.oasthook.com
Offices in Virginia Beach, Virginia and Portsmouth, Virginia
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