Understanding ‘Community Spouse’ in Medical Assistance Context: A Guide from a Minnesota Elder Law Attorney

Nov 21, 2023

When navigating the intricacies of Medical Assistance, particularly when planning for long-term care, you’ll encounter terms that might be unfamiliar yet profoundly influential. One such term is “community spouse.” As your local Minnesota elder law attorney, I’m here to demystify this concept and its implications for Medical Assistance eligibility and benefits.

What is a ‘Community Spouse’?

A “community spouse,” sometimes referred to as the “well spouse,” is the husband or wife of a Medical Assistance applicant who is not applying for Medical Assistance benefits and continues to live in the community (as opposed to a nursing home or other long-term care facility). This distinction is significant because Medical Assistance recognizes the financial needs of the community spouse and offers certain protections to prevent impoverishment.

Key Provisions for the Community Spouse:

  1. Community Spouse Resource Allowance (CSRA): This is a certain amount of the couple’s combined assets that the community spouse is allowed to retain without affecting the other spouse’s eligibility. The specific amount can vary by state and change yearly, so it’s vital to check current limits.
  2. Monthly Income Allowance: Recognizing that the community spouse might need support, Medical Assistance allows a certain amount of the institutionalized spouse’s income to be allocated to the community spouse. This is to ensure the well spouse has sufficient funds for their living expenses.
  3. Fair Hearing Adjustments: If the standard allowances are insufficient to meet the community spouse’s needs, it might be possible to obtain a higher allowance through a fair hearing.

Planning Considerations:

Medical Assistance planning with a community spouse can be complex, but it’s vital to maximize the protections available. Proper planning can:

  • Ensure the community spouse maintains a comfortable standard of living.
  • Secure quality care for the institutionalized spouse.
  • Preserve family assets to the greatest extent possible.

Consult with a Minnesota Elder Law Attorney

Understanding and navigating the rules related to the community spouse in Medical Assistance can be challenging. As an experienced Minnesota elder law and estate planning firm, we’re equipped to provide guidance tailored to your unique situation.

If you’re considering Medical Assistance planning or have concerns about the community spouse rules, don’t hesitate to reach out. Contact us at 763-244-2949 to schedule you consultation and be sure to mention this article for a focused discussion on your specific needs.