Effective September 30,1989, legislation (Section 303 of the Medicare Catastrophic Act) was passed to change the way Medicaid calculates a couple's resources so that the community spouse would not become impoverished. This policy allows for resource and income allowances for the community spouse. To be considered as a spousal impoverishment case, one spouse must be institutionalized or planning to be institutionalized and one spouse living in the community.
Income received by the community spouse is not counted when determining income eligibility for the applicant. The community spouse's income is counted when determining how much of the applicant's income will be set aside for the community spouse's monthly maintenance needs allowance.
Under the 1989 legislation, Medicaid counts all of the couple's resources together - everything owned by one or the other spouse, and all of the jointly owned resources to determine a case total. The total is then split in half, with half attributable to the community spouse and half to the applicant spouse. If the community spouse's half is less than $25,000 an amount may be taken from the applicant spouse's portion to bring it up to $25,000.
If the community spouse's half is more than $87,000.00 (eff. 01/01/01), whatever is in excess is attributable to the applicant spouse and would have to be spent on his/her care.
If the case total is less than $27,000, the applicant may be found eligible for Medicaid.
If the case total is above the $27,000, they would receive a calculation summary and a target amount for the case total.When the case total was within the limits applicant would have to reapply.