When a spouse requires long-term care it can result in devastating financial hardship for the healthier spouse. There are special federal and state laws, however, that prevent the healthier spouse from being impoverished. One of these provisions of the laws concerns spousal support.
Usually a person who receives Medicaid must provide all of his or her monthly income to the nursing home facility. Medicaid then pays the balance. There are special rules, however, that govern a married individual’s monthly income. The healthier spouse may be entitled to spousal support based upon a number of factors, including shelter expenses.
According to federal law, the amount that is spent on certain shelter expenses can increase the amount of the spousal support that Medicaid allows. The amount that a healthier spouse is entitled to receive for shelter expenses is known as the “shelter allowance”.
According to 42 U.S.C. §1396r-5 (d) (4), the amount of the shelter allowance is equal to the amount by which the community spouse’s shelter expenses, including utilities, exceed 30% of one-twelfth of 150% of the poverty line for a family of two. Since the poverty level for a family of two is currently $19,720.00, the shelter standard is $739.50.
The New Jersey Division of Medical Assistance and Health Services issued a special directive to the 21 counties in New Jersey, known as a “Medicaid Communication”. According to Medicaid Communication No. 23-05, the excess shelter standard has been increased from $686.63 to $739.50 effective July 1, 2023.
Since the shelter standard is now $739.50, the monthly shelter expenses for a healthier spouse must exceed $739.50. The amount that the shelter expenses exceed $739.50 will result in an increase in spousal support. These shelter expenses, however, are limited to rent, mortgage, property taxes, homeowner’s insurance and utility expenses.
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