Medical Assistance for Long-Term Care Services
2.4.2.1 Asset Evaluation for Married Couples
An asset evaluation is required for married couples when one spouse is requesting Medical Assistance (MA) for Long-Term Care (LTC) and the other spouse is considered a community spouse.
Long Term Care (LTC) Spouse
An LTC spouse is a married person who:
- Resides in a long term care facility (LTCF) or receives Elderly Waiver program services, and is expected to remain in the LTCF or receive EW services for at least 30 consecutive days; and
- Has a community spouse
Community Spouse
The community spouse is someone who:
- Is married to an LTC spouse; and
- Who does not reside in a LTCF and dose not receive waiver services from Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Developmental Disability (DD), or Elderly Waiver (EW) programs.
A community spouse can receive MA, MinnesotaCare or services through the Alternative Care (AC) program.
Asset Evaluation
At the time of a request for MA-LTC, the LTC spouse and community spouse must report and verify all assets individually or jointly owned by either spouse, regardless of whether the asset is excluded.
The asset evaluation:
- Determines the amount of the couple’s total assets.
- The couple uses the amount to determine which assets they will protect for the community spouse, known as a Community Spouse Asset Allowance (CSAA).
- The remaining assets that are not designated toward the CSAA are evaluated in an asset eligibility determination for the LTC spouse, See section 2.4.2.1.2.1 MA-LTC Asset Eligibility for a Long-Term Care Spouse
- The couple uses the amount to determine which assets they will protect for the community spouse, known as a Community Spouse Asset Allowance (CSAA).
- Is only required when the LTC spouse’s basis of eligibility is MA for:
- People Who Are Age 65 or Older or People Who Are Blind or Have a Disability (MA-ABD), or
- Families with Children and Adults (MA-FCA) with a spenddown.
- Is not required when the LTC spouse’s basis of eligibility is MA for:
- Families with Children and Adults (MA-FCA) without a spenddown, or
- Employed Persons with Disabilities (MA-EPD)
Whereabouts of the Community Spouse are Unknown
When an asset evaluation is required and the LTC spouse does not know the whereabouts of the community spouse, the LTC spouse must make a reasonable effort to locate the community spouse.
If reasonable efforts to locate the community spouse do not succeed, eligibility for MA-LTC for the LTC spouse is still possible. The LTC spouse must report assets on the application based on the information they know about the community spouse’s assets.
Notification Requirements and Appeal Rights
The LTC spouse, the LTC spouse’s authorized representative, if applicable, and the community spouse must be notified of the results of the asset evaluation using DHS-3340A. Any of these people may appeal the results.
New Asset Evaluation
A new asset evaluation is required if a person has a break in LTC eligibility of one calendar month or more and the county or tribal nation servicing agency receives a new request for MA-LTC. An asset evaluation is not used to determine asset eligibility if an enrollee receiving MA-LTC marries a person who meets the definition of a community spouse after eligibility for MA-LTC is approved.
Legal Citations
United States Code, title 42, Section 1396r-5(h)
Minnesota Statutes 256B.059