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Medicaid Planning for Married Couples

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“Medicaid Planning for Married Couples” by Attorney Laura Curry (Audio)

Medical assistance in Maryland is provided through a joint federal-state program that can pay for care in a nursing home or rehabilitation facility for low-income individuals of all ages. It is important to know and understand the Maryland Medical Assistance, or Medicaid Eligibility Rules when thinking about planning for long term care or if you or a loved one is needing long-term care immediately or in the near future.

In order to qualify for Medicaid, a single person can have no more than $2,500 in countable assets.  At first glance, this number is alarmingly low.  You may be asking, how can anyone ever qualify with such a low figure?  That is where Medicaid planning comes into focus.

Medicaid planning is different for married couples and unmarried individuals as the Medicaid Assistance rules are different and there are special rules for the non-nursing home spouse (or the community spouse) in terms of their assets and income.

For a married couple where one spouse is in a nursing home, the nursing home spouse still must have no more than $2500, but the spouse still living at home can keep one half of the combined assets up to a maximum of $126,420 (for 2019).  This is referred to as the Community Spouse Resource Allowance (CSRA). Furthermore, assets are defined as countable or non-countable or exempt assets under the Medicaid Assistance rules. Countable assets include cash, stocks, bonds, investments, retirement accounts, credit union, savings, and checking accounts and real estate in which one does not reside. However, for Medicaid eligibility, there are many assets that are considered exempt (non-countable). Exempt assets include personal belongings, household furnishings, an automobile, irrevocable burial trusts, one’s primary home as long as the home is valued under $585,000 (for 2019).

The non-nursing home spouse’s income is not counted by Medical Assistance when you apply for eligibility. Furthermore, if your spouse’s income is less than a certain amount as defined by Medical Assistance, then your spouse can have an allowance from your income.  This is referred to as the Minimum Monthly Needs Allowance (MMMNA). This allowance may be increased if your spouse’s housing costs for rent, mortgage, property taxes, homeowner’s insurance and utilities are more than a certain amount per month.

It is critical to start Medicaid planning as early as possible as there are strategies that may be available to you if you plan prior to the five year look-back period. There are also planning techniques that allow you to spend down your countable assets without having a gift transfer penalty imposed and to qualify for Medicaid as quickly as possible.

The rules are complicated and change frequently so it is important for you to speak to an elder law attorney to discuss the best planning options for you. If you or a loved one would like to discuss your options, contact us at Sinclair Prosser Gasior for an appointment.

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