8142 Other Resource Provisions

1.   The combined resources of two spouses shall be considered only for the month

the institutional arrangement begins in the following situations:

a.One spouse enters a medical institutional (whether or not the facility is Medicaid

approved) prior to September 30, 1989 for other than a temporary stay as defined

in 8113;  

b. Both spouses enter a medical or non-medical institutional living arrangement (whether

or not the facility is Medicaid approved) for other than a temporary stay as defined

in 8113; or  

c. One spouse enters a nonmedical institution.  

If the community spouse is also an applicant or recipient of any medical program, (including HCBS), the community spouse resource allowance is considered available to the community spouse to determine eligibility of the community spouse, beginning in the month the arrangement begins.  

d. This includes those assets in which the community spouse has no current ownership

interest. If the couple’s total combined resources are less than the minimum community

spouse resource allowance, the total combined resources less the one person resource

standard (currently $2,000) is considered available to the community spouse.  

e. In the month following the first month of eligibility of the LTC spouse, only those

assets in which the applicant or recipient has ownership interest in shall be considered

in the determination of eligibility for each individual spouse. Those assets which

intend to be transferred to the community spouse per the M-2 are attributable to

the community spouse when determining his or her eligibility. The pro rata share

of jointly owned resources shall be considered.

NOTE: If only a one spouse entered a medical institution or HCBS arrangement prior

to September 30, 1989 but returns to an independent living arrangement for at least

30 consecutive days, the provisions of 8141 above shall apply if he or she returns

to the institutional arrangement on or after September 30, 1989.  

2.   There is no resource test for a child or young adult under the age of 21 who enters an institutional living arrangement (whether or not the facility is Medicaid approved). A resource test is applicable the month after the month the individual turns 21 years old.

Parents of children under the age of 18 in state institutions may retain a legal obligation for payment of costs above those covered by the medical program. Parental obligation will be established by institutional personnel.

3.    Individuals applying for medical assistance to cover the cost of institutional care have the option of making a voluntary contribution of excess resources towards the patient liability in order to become resource eligible.  This provision allows applicants otherwise ineligible for coverage due to excess resources to qualify by counting the amount of excess resources as income in determining the patient liability.  See 5200 (14) and 8172.4.

This provision also applies to institutional care recipients with excess resources.  In addition, otherwise unspent exempt income which over time results in excess resources may also be voluntarily contributed by an institutional care recipient towards the share of cost in an on-going basis to maintain resource eligibility.