There is a tremendous cost associated with nursing home care for a spouse. Most nursing home facilities charge approximately $12,000 to $13,000 each month for a semi-private room. Medicaid will pay for nursing home care, but only after the family’s assets have been depleted.
There are special laws that prevent the healthier spouse from being impoverished. Elder law attorneys often refer to these laws as the spousal impoverishment provisions of the Medicaid laws. According to applicable federal and state Medicaid laws, the healthier spouse can keep the house, automobile, personal effects and a portion of the remaining assets. The portion of the remaining assets that the healthier spouse can keep is known as the Community Spousal Resource Allowance, also known as the CSRA.
The healthier spouse can keep one half of the remaining assets but no greater than a certain amount. There is also a minimum amount that the healthier spouse can keep. Last year the minimum CSRA was $27,480. This year the minimum CSRA has increased to $29,724.
If a married couple has more than $60,000 of cash assets then the healthier spouse can keep the lesser of one half of the cash assets but no more than a maximum amount. This is known as the maximum CSRA. Last year the maximum CSRA was $137,400. This year the maximum CSRA is $148,620.
By way of illustration, if a married couple owns a house, car and $500,000 of cash assets, then Medicaid allows the healthier spouse to keep the house, car and $148,620 of the cash assets. The balance of the cash assets of approximately $351,000 will have to be spent down in order to allow the institutionalized spouse to qualify for Medicaid assistance.