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Protected Spousal Amount 2.9.1

Impoverished Spouse: The Protected Spousal Amount is the greatest of the following amounts:

 the Spousal Share, provided it does not exceed $115,920.00 for 2013 (see Section 2.9.2: Spousal Share in this Chapter);  the Community Spouse Assets Allowance ($23,184 for 2013);  an amount transferred under a court support order (court-ordered support); or  an amount designated by the OAH

Protected Spousal Amounts are revised:

 when either spouse alleges that the initial determination was incorrect and the OAH confirms such allegations (see Section 7.4.8: Hearing Decisions in Part VIII), or  when a SSR determines that inaccurate information was provided at the time the Spousal Share was calculated for the current eligibility period.

If either spouse establishes during redetermination of eligibility that income generated from the Protected Spousal Amount is inadequate to raise the community spouse's income to the minimum monthly maintenance needs allowance (see Section 2.6.6: Community Spouse Monthly Income Allowance in this Chapter), recalculate the Protected Spousal Amount.

Spousal Share 2.9.2

Impoverished Spouse: The Spousal Share is equal to one-half of the couple's combined countable assets as of the beginning of the most recent continuous period of institutionalization. Spousal Shares are calculated between the time a spouse is admitted to an institution and the time the spouse applies for Medicaid and eligibility is determined. Calculation may be made even when there are no immediate plans for an institutionalized spouse to apply for Medicaid.

The amount of the Spousal Share remains the same for purposes of determining the amount of assets used to determine the institutionalized spouse's initial Medicaid eligibility in the current period. It does not change even when calculated prior to application.

Example

Mr. and Mrs. Lopez's combined countable assets at the time of Mr. Lopez's Medicaid application are $12,000. The Community Spouse Assets Allowance is $23,184. All of the couple's assets ($12,000) are protected for the community spouse because they are below the Community Spouse Assets Allowance of $23,184. Therefore, the Protected Spousal Amount is $12,000. Example Mr. and Mrs. Smith's combined countable assets are assessed at $20,000 at the beginning of the most recent continuous period of Mr. Smith's institutionalization. The Spousal Share is $10,000 (one-half of the initial asset assessment amount).