A great many disabled adults in Mississippi, including a number of our clients, receive Medicaid assistance (personal care attendants, home-delivered meals, adult day care) through the Medicaid Elderly & Disabled Waiver program. The recipient of such services must have less than $4,000 of “countable” assets to qualify, and the state has the option to allow a greater amount of marital assets to be owned by the non-disabled spouse under “spousal impoverishment” rules.
The Centers for Medicare & Medicaid Services (CMS) has released an informational bulletin informing states that their Medicaid agencies are required under the Consolidated Appropriations Act of 2023 (CAA) to apply the spousal impoverishment rules to married applicants and beneficiaries eligible for home- and community-based services (HCBS) through September 30, 2027. Under “spousal impoverishment rules,” states can disregard or not include in their eligibility calculations some income and assets of married individuals when one of the spouses needs long-term services and supports in a nursing home. The Affordable Care Act authorized the same spousal impoverishment rules to apply to people seeking HCBS. This promotes community living by removing a financial incentive for a Medicaid beneficiary to receive services in a nursing home rather than in their own home. That authorization was set to expire in 2018 but has been extended several times, most recently in the CAA, until September 30, 2027.
Under “spousal impoverishment” rules for married applicants in Mississippi, the nn-applicant spouse may keep all of his/her own separate income, plus enough of the applicant’s income to get the non-applicant’s income up to $3,715.50 per month (the “monthly maintenance needs allowance”) (2023) if his/her separate income is less than this amount. The non-applicant spouse may own separate countable resources of up to $148,620 (the “community spouse resource allowance”). Assets may be transferred from the applicant spouse to the non-applicant spouse to achieve these levels. Medicaid transfer penalties may be imposed for uncompensated transfers of resources by the applicant or the applicant’s spouse to others.
https://www.medicaid.gov/sites/default/files/2023-08/cib08152023.pdf