Community Spouses: What They Are and Why They Are Important

You might have heard the term “community spouse” and wondered what it means. Essentially, if one spouse receives long-term care in a nursing home, the spouse living outside the nursing home is considered the community spouse. Here, our legal team explains why community spouses are important. Continue reading to learn more or contact one of our experienced Santa Clara elder law attorneys for assistance.

What Is a Community Spouse?

 A community spouse is a person who resides in the community while their spouse receives Medicaid-funded, long-term care in a nursing home or another institution. Because nursing home care can be expensive, Medicaid includes provisions to prevent “spousal impoverishment.” This can occur when the spouse still living at home is left with little or no income or resources. The provisions aim to prevent this situation and help community spouses continue to live independently.

Why Is a Community Spouse Important?

 The costs of living in a long-term care facility can be high. A couple’s shared savings can quickly dwindle when a spouse moves into a nursing home. When this happens, the community spouse may be unable to take care of their basic needs. Under the Medicaid provisions, some of the couples’ shared assets will be protected, allowing the community spouse to live independently. Additionally, a portion of the income of the spouse who is in the nursing home may (in some circumstances) be set aside for the community spouse. The well-being of a community spouse is integral to ensuring that a married couple can maintain their standard of living, whether at home or in a care facility.

Prevention of Spousal Impoverishment

 The Community Spouse Resource Allowance (CSRA) is the portion of a couple’s assets that are protected for the community spouse. The CSRA is calculated based on a couple’s shared resources. The value of the couple’s assets is determined on the day one spouse enters a long-term care facility, also called the “snapshot” date. For the spouse in a nursing home to qualify for Medicaid, their individual assets must be no greater than $2,000 (or $130,000 in California). A couple’s shared resources may require redistribution for the spouse to be eligible for Medicaid.

In many states, the community spouse may keep up to 50 percent of shared assets. However, some states allow the community spouse to maintain up to 100 percent of the couple’s assets. Regardless, there is a maximum dollar amount that applies. The 2022 CSRA maximum limit is $137,400.

Calculating CSRA

 Calculating CSRA will depend on the couple’s assets and where they reside. For instance, the community spouse in a couple with shared assets of $100,000 living in a state with a 50-percent rule may keep up to $50,000 of the shared resources. The remaining $48,000 must be “spent down,” for example by putting it toward home improvements or paying off debt. On the other hand, the community spouse in a state with a 100-percent rule may keep the remaining amount of the shared assets, equal to $98,000 in this scenario.

Other Considerations

 There are other considerations if you or your spouse is entering a long-term care facility. For instance, other Medicaid provisions to protect a community spouse include determining a minimum monthly maintenance needs allowance (MMMNA). An experienced Santa Clara elder lawyer can help you decide the best way to ensure your financial stability for years to come. Contact our law firm today at 408-889-1290 to schedule a consultation.