Your spouse is receiving long-term care and may need Medicaid at some point in the future. Does that mean that all your assets must be depleted before your spouse can qualify for Medicaid? The short answer: No. However, careful planning needs to be done to ensure that the non-applicant spouse can maximize the assets that he or she is entitled to keep in order for his or her spouse to still qualify for Medicaid.
Medicaid is the only government benefit that helps qualifying persons pay for their long-term care costs. Specifically, in New Jersey, Medicaid will cover care costs in an at-home setting, assisted living facility, and skilled nursing facility. An applicant must meet certain financial and clinical requirements to qualify for Medicaid. Specifically, the applicant cannot have more than $2,000 in his or her name before he or she can financially qualify for Medicaid. Additionally, if the applicant has a spouse (and assuming that spouse does not also need to qualify for Medicaid and is residing in the community), he or she can keep half of the marital assets. This includes assets in each spouse’s individual name and any jointly held assets. This is referred to as the Community Spousal Resource Allowance (“CSRA”). In any event, the non-applicant spouse cannot keep more than the maximum CSRA, which is presently $154,140 for 2024.
There are some assets that are considered “non-countable” for Medicaid purposes that the non-applicant spouse may keep in addition to his or her CRSA. Some non-countable assets include 1) the primary residence, so long as the non-applicant spouse is residing there and the residence is titled solely in his or her name 2) one vehicle, 3) household and personal effects up to $2,000, and 3) wedding ring and/or engagement ring. Accordingly, the non-applicant spouse can keep these non-countable assets in addition to his or her CSRA.
Timing is extremely important for purposes of determining the non-applicant spouse’s CSRA. The CSRA is determined upon the earlier to occur of the first day of the first month of the applicant’s spouse needing continuous institutionalized care or an application for Medicaid benefits. This is referred to as the “snapshot.”
For example, if the applicant and his or her spouse have $400,000 of countable assets on the first day of the first month that the applicant begins receiving continuous institutionalized care, then the non-applicant spouse can keep half of those assets, up to the maximum CSRA of $154,140. Accordingly, in this example, the non-applicant spouse can keep the maximum CSRA of $154,140.
However, the snapshot can be tricky because not all long-term care is considered “institutionalized.” Therefore, if your spouse is receiving or about to receive long-term care in any setting and you believe that Medicaid may be necessary in the future, it is imperative that you reach out to an elder law attorney to discuss the Medicaid planning and application process.
If you or a loved one are faced with decisions regarding long-term care or the need to qualify for Medicaid, please call us to discuss how to navigate your way through the planning process.
