Medicaid eligibility rules for married long-term care Medicaid applicants are different from rules for an unmarried person. Before reviewing the process, I think it would help to explain some terms.
- Institutionalized Spouse: the spouse residing in a skilled, long-term care facility
- Community Spouse: the spouse residing at home (or in an assisted-living facility)
- Resource Assessment: A pre-application screening process involving the Medicaid office to determine the amount of a married couple's resources and what spend down will be in order to achieve Medicaid eligibility.
- Spend Down: The post-Resource Assessment process of allocating resources and/or spending resources to achieve Medicaid eligibility for the Institutionalized Spouse.
The Medicaid rules for a married applicant are designed to protect the Community Spouse from impoverishment given the high monthly costs of nursing care. As such, the Community Spouse is allowed to keep some of the couple's resources.
Before any Medicaid application can be made, there first must be a Resource Assessment. This requires gathering all necessary documentation regarding a couple's resources and meeting with a Medicaid caseworker. Before applying for a Resource Assessment, I will typically perform my own Resource Assessment as a test run before going to the Medicaid office. It's important to do this so I can catch potential errors of a Medicaid caseworker and to allow for the client to know what to expect once the Resource Assessment is obtained.
The Resource Assessment itself involves several steps concerning how assets are categorized, a determination of the Community Spouse Resource Allowance, as well as the Excess Resources that would be spent down.
Once assets are spent down or reallocated to the sufficient numbers, a Medicaid application can be filed at last.
For more information on the workings of the long-term care Medicaid application process in Kentucky, contact Darpel Elder Law today.
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