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Medicaid Eligibility Manual Eligibility Factors
Reissued March 18, 2025 Replacing March 5, 2024 Page 8 of I-1660 Revised/added text indicated by underscore Deleted text indicated by “”
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The institutionalized spouse is resource eligible if the couple signs acknowledgements of spousal transfer policy (Form 4 LTC/SP-R1).
Determine resource eligibility for the applicant/beneficiary at the first renewal of eligibility or subsequent application for assistance. Include all countable resources retained in the name of the institutionalized spouse. If allocated resources were not transferred, advance notice is required prior to any termination of coverage.
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Additional resources acquired after certification by the institutionalized spouse may be transferred to the community spouse to the extent that the maximum has not already been transferred.
Example: Mrs. Jones entered a nursing facility 1-1-2005, Spousal Resource Standard $95,100.00 for institutionalized spouse. Mr. Jones had $20,000.00 in resources, Mrs. Jones had $20,000.00 in resources, and they had $10,000.00 joint resources. Mrs. Jones transferred her resources and her share of the joint resources to Mr. Jones which gave him a total of $50,000.00 in resources. Two years later, Mrs. Jones receives an inheritance of $20,000.00 which is over the resource allowance for an institutionalized individual. (The inheritance is counted as income in the month it is received.) In the same month she received the inheritance she transferred it to Mr. Jones. The transfer is allowed as long as the amount is below the maximum resource allowance at the time Mrs. Jones entered the facility. $50,000.00 + $20,000.00 = $70,000.00 which is below $95,100.00.
An increase in or additional resources acquired by the community spouse after certification has no effect on resource eligibility for the institutionalized spouse.
Example: Mrs. Jones enters a LTC facility. The spousal allocation of resources is done and the resources transferred to Mr. Jones before the first renewal. Mr. Jones retains the allocated resources and uses them appropriately to meet his needs. Three years later, Mr. Jones is involved in an accident and receives a very large settlement. Even though Mr. Jones might now have resources above the spousal resource