Medicaid is a needs-based program that will pay for long-term care. Since it is a needs-based program, there are income and asset limits for the applicant, but what if the applicant is married? When a Medicaid applicant is married, they refer to their spouse as the “community spouse.” There are a separate set of guidelines for an applicant to qualify based on their community spouse in addition to the applicant’s individual guidelines. Each community spouse receives a resources allowance so that the community spouse is not required to deplete their assets for their spouse to be eligible for Medicaid benefits. 

Stethoscope next to a chalkboard that says Medicaid

Community Spouse Resources Allowance

The community spouse resources allowance is the allowed amount of countable assets (separate from income) that the community spouse can keep while the applicant is receiving Medicaid benefits. The allowance can range from $27,480 to $137,400. This table shows how the amount varies:

 

Total Countable Assets

Amount Protected

$27,480 or less

Everything

$27,480.01 to $54,960

$27,480

$54,960.01 to $274,800

One Half of the Value

$274,800.01 or more

$137,400

 

There are various rules for what is and is not a countable asset. An experienced elder law attorney can help you determine the value of your countable assets, as it can vary person to person. One important rule to note is that there is an allowance for the applicant on the value of their home, and the community spouse is allowed to stay in the home–even if the applicant has passed away. 

Minimum Monthly Maintenance Needs Allowance

The Minimum Monthly Maintenance Needs Allowance (“MMMNA”) is the allowed amount the community spouse can take from the applicant’s income before Medicaid possibly takes it if the spouse’s income is less than the applicant’s. 

The current MMMNA in North Carolina is $2,178 per month, so if the applicant’s spouse makes less than $2,178 per month, the difference can be made up with the applicant’s income. 

The MMMNA can be increased up to $3,435 per month depending on the applicant’s circumstances. The increased allowance allows for 

  • Shelter costs, which can include rent or mortgage payment, 
  • Taxes on the home, 
  • Homeowner’s or renter’s insurance, 
  • Required maintenance charges or homeowners’ association fees, or
  • Utility costs. 

If an applicant is married with a dependent at home under the spouse’s care, then there is an additional allowance the applicant can claim for the dependent. The current dependent income allowance for an applicant is $726 per month (or one-third of the base MMMNA). 

If you are unsure if you or a loved one would currently qualify for Medicaid benefits and may need to apply soon, please give our office a call at 919-443-3035 or visit our website to schedule a free needs assessment call. 

Additional Information on North Carolina Medicaid Assistance for Nursing Home Care:

Download a free copy of Jackie Bedard’s book, The Ultimate Guide to Paying for Nursing Home Care in North Carolina, to learn the nursing home and Medicaid secrets you need to know to avoid going broke in a nursing home and leaving your family penniless.


 
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