When a married person applies for Medicaid, the Medicaid agency must analyze the income and assets of the applicant and the applicant’s spouse as of a particular date to determine eligibility. Elder Law attorneys refer to this as the “snapshot” date. It can have a major impact on a couple’s financial future.
In order to be eligible for Medicaid benefits a nursing home resident in Pennsylvania may have no more than $8,000 ($2,400 for higher income applicants) in “countable” assets. Countable assets are those that can be accessed by the applicant or his or her spouse. Non-exempt assets in a revocable trust, since accessible, are countable. On the other hand, assets in a Medicaid Asset Protection Trust, although not exempt, are not countable because they are not accessible.
As regards income, a Medicaid recipient must pay over his income toward the cost of care. But the community spouse may keep all of her income and, if that income falls below a certain threshold, she may keep some or possibly all of the applicant’s income as well. The determination as to how much, if any, income of the institutionalized spouse may be diverted to the community spouse is based upon the spouse’s income and “shelter”, that is, housing costs.
As regards a married couple’s asset, in Pennsylvania, the community spouse may keep one-half of the couple’s total “countable” assets in existence on the “snapshot” date up to a maximum of $137,400 (in 2022). This is the community spouse resource allowance (CSRA), the most that a community spouse may keep without an administrative hearing. In all cases, the spouse may retain, as a minimum $27,480 (in 2022), provided that amount remains as of the date an applicant qualifies for benefits. Timing is therefore crucial.
The snapshot date, that is, the date Medicaid uses to analyze the applicant’s assets, affects how much money the applicant must spend down before qualifying for benefits and how much a spouse is able to keep. It is called the “snapshot” date because Medicaid is taking a picture of the applicant’s assets as of this date.
The snapshot date is the day on which the Medicaid applicant enters either a hospital or a long-term care facility in which he or she then stays for at least 30 consecutive days. If the applicant enters a hospital or nursing home, stays for 30 days, goes home, and then reenters a hospital or nursing home, the snapshot date is the date the applicant entered the hospital or nursing home for the first stay.
Not all Medicaid long-term care applicants are in an institution. If the applicant is applying for Medicaid home care through Pennsylvania’s waiver program, Community Health Choices, the snapshot date is the date the applicant is determined to need a nursing home level of care.
On the snapshot date, the Medicaid agency counts up all of an applicant’s and his or her spouse’s assets, excluding the couple’s exempt assets. Exempt assets include the home and one motor vehicle. Then depending on the CSRA ($137,400 in 2022), the agency determines how much the community spouse can keep. If any assets above the applicant’s $8,000 (or in some cases $2,400) resource limit remain, then that money must be spent down before the applicant will qualify for benefits.
Example: If a couple has $100,000 in countable assets on the snapshot date the Medicaid applicant will be eligible for Medicaid once the couple’s assets have been reduced to a combined figure of $58,000 — $8,000 for the applicant and $50,000 for the community spouse.
Proper planning can help a couple determine the best time to apply for benefits based on the snapshot date and to maximize the assets the couple can keep. Moreover, with the help of a qualified elder law attorney, some or all of the excess resources otherwise subject to spend down can be legally protected for spouse or other loved ones.
The attorneys at Vasiliadis Pappas Associates have helped thousands of Clients qualify for Medicaid while protecting assets for loved ones. We can help your family too.
Contact Vasiliadis Pappas Associates for assistance if you or a loved one encounters this situation.