DSS: CHCPE - Assessment of Spousal Assets

CHCPE - Assessment of Spousal Assets

{CHCPE logo and link to main page.}


Assessment of Spousal Assets

Under state and federal law, a married couple is allowed to protect assets for the spouse living in the community when the other spouse is institutionalized. The Department of Social Services defines institutionalization as a continuous stay in a medical or long term care facility for a period lasting 30 or more consecutive days. The date of institutionalization is the date of admission to a medical or long term care facility or the date the Department determines the applicant to be in medical need of community based services. The assessment of spousal assets is completed using the assets, which existed as of the beginning of the initial continuous period of institutionalization, which started on or after September 30, 1989.

To determine the amount of assets that may be protected, the Department completes an assessment of spousal assets. The purpose of the spousal assessment is to determine how much of the coupleís countable assets may be protected for the community spouse. The value of the protected assets of the community spouse are not counted when the eligibility of the institutionalized individual is determined.

The amount of assets that can be protected is determined by adding together the counted assets of both spouses as of the date the institutionalized individual is considered to be institutionalized and dividing the amount in half to establish a spousal share. Effective January 1, 2010, the Community Spouse Protected Amount (CSPA) is equal to the spousal share up to a maximum of $109,560.00 or to a minimum of $21,912.00. Federal law sets the maximum and minimum amounts and the state is required to update the amounts January 1st of each year. The CSPA cannot exceed the maximum amount, except by Fair Hearing decision or through a court order. It is often helpful to request an assessment of assets as soon as you are in need of home and community based services because it will usually increase the amount of assets/resource that can be protected for the community spouse. The countable assets of the institutionalized spouse cannot exceed $1,600.

When an institutionalized individual and his or her spouse have assets which exceed the amount established as the CSPA and the $1,600.00 asset limit, the excess assets are considered to be available to the institutionalized individual. This is true regardless of which spouse is the owner of the assets. The institutionalized individual is not eligible for Medicaid until the coupleís combined assets are reduced to the total of the $1,600 asset limit and the CSPA. The couple is not required to "spenddown" the excess to pay for the institutionalized individualís medical expenses. As long as fair market value is received, the excess assets may be spent in any way the couple wishes.

As assessment of spousal assets may be completed at the request of either spouse anytime prior to application for Medicaid. If an assessment of spousal assets is not completed prior to a Medicaid application, an assessment must be completed at the time the Medicaid application is filed.

If you are applying for Medicaid there is no fee for the assessment of spousal assets, if you are not applying for Medicaid at the time of the request, there is a fee of $50.00 for the assessment of spousal assets. This fee must be paid before the assessment can be completed. After a review of the information, the Department will notify the applicant in writing of the decision. The results of the assessment will be retained by the Department and used to determine eligibility if the person later applies for Medicaid.

If a couple believes they qualify for a spousal assessment they may request this assessment by submitting a Home Care Request Form (W-1487) to the Department or by calling the Departmentís toll free number, 1-800-445-5394, to initiate the process.

You can click the link below to access the printable Home Care Request form. 

Program Application

Content Last Modified on 1/7/2010 12:29:31 PM