Medical Assistance for Long-Term Care Services

2.4.2.1.2 Community Spouse Asset Allowance

At the time of a request for Medical Assistance for Long-Term Care Services (MA-LTC), the LTC spouse who has a community spouse must report and verify their assets. An asset evaluation is used to calculate which assets are protected for the community spouse. The assets that the community spouse is allowed to keep is called the Community Spouse Asset Allowance (CSAA).

There are many factors that a couple must consider when deciding which of the couple's assets are included in the CSAA, including tax implications as well as personal factors such as the desire to retain ownership of a particular asset. The decision on how to divide the couple’s assets is up to the couple. The couple can contact a tax accountant, an attorney or someone who specializes in estate planning for questions unrelated to Medical Assistance (MA) policy.

Determining the Community Spouse Asset Allowance

The CSAA includes the couple’s total countable assets as determined by the asset evaluation. The couple must provide proof of the value of all of their assets, regardless of whether the asset is excluded or unavailable.

The total value of the couple's countable assets are compared to the maximum CSAA. The community spouse may keep up to the maximum asset allowance in effect on the date of the request. The maximum CSAA is updated annually.

The remaining assets that do not make up the CSAA are evaluated in an asset eligibility determination for the LTC spouse, to determine whether the LTC spouse meets the MA asset limit. If the couple's assets exceed the CSAA and the MA asset limit, the LTC spouse may have to reduce assets before MA can be approved.

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.

A new asset evaluation is required if a person has a break in LTC services of one calendar month or more and the county or tribal agency receives a new request for MA-LTC.

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, they 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. The signature of the community spouse on the Account Validation Service (AVS) authorization (DHS-7823) is not required to complete the CSAA.

Notification requirements

The LTC spouse, the LTC spouse's authorized representative, if applicable, and the community spouse must be notified of the CSAA. Any of these individuals may appeal the results.

Increased Community Spouse Asset Allowance

The CSAA is increased beyond the maximum CSAA in the following situations:

Additional Income-Producing Assets to Meet Community Spouse’s Monthly Maintenance Needs

A community spouse may keep additional income-producing assets above the CSAA, if he or she cannot meet his or her monthly maintenance needs with the income allocated from the LTC spouse combined with his or her own income.

The couple must meet the following requirements for the community spouse to keep additional income-producing assets above the CSAA:

Transfers from the LTC Spouse to the Community Spouse

Assets considered available to the community spouse through the CSAA must be put in the community spouse’s name no later than the LTC spouse’s next annual renewal. At the LTC spouse’s next annual renewal, all assets still in the name of the LTC spouse are evaluated in order to determine asset eligibility.

Transfers from the Community Spouse to the LTC Spouse

Ownership of assets that are in the community spouse's name but are not included in the CSAA and do not have to be reduced must be transferred to the LTC spouse. Transfer of ownership must be verified before MA-LTC eligibility may be approved.

Community Spouse Does Not Make Assets Available to the LTC Spouse

The community spouse must make assets owned jointly or individually in excess of the CSAA available to the LTC spouse. If the community spouse does not make those assets available, the LTC spouse may still be found eligible for MA-LTC if the LTC spouse cannot use those assets without the consent of the community spouse, and if any of the following occurs:

A person whose request for a hardship waiver is denied can appeal the denial. When MA-LTC is approved under this provision, the county or tribal agency makes a referral to the county attorney’s office to determine if a cause of action exists against the community spouse.

Treatment of the Community Spouse’s Assets after MA-LTC Approval

Once MA-LTC has been approved, any additional assets acquired by the community spouse are not available to the LTC spouse, as long as there is no break in MA-LTC eligibility for one calendar month or more and the county or tribal agency receives a new request for MA-LTC.

Legal Citations

Minnesota Statutes, section 256B.059

Minnesota Statutes, section 256B.0913, subdivision 12