Medical Assistance for Long-Term Care Services

2.4.2.1.2.1 Asset Eligibility for a Long-Term Care Spouse

The couple’s remaining assets that are not designated toward the CSAA are evaluated in an asset eligibility determination for the LTC spouse, to determine whether the LTC spouse meets the MA asset limit.

Transfers from the Community Spouse to the LTC Spouse

Countable assets the couple has chosen not to protect in the CSAA are considered available to the LTC spouse when determining MA eligibility for the LTC spouse. These assets must be transferred to the LTC spouse. Transfer of ownership must be verified before MA-LTC eligibility may be approved.

Availability of Assets

The LTC spouse’s assets are evaluated using the applicable policy:

• MA for People Who Are Age 65 or Older and People Who Are blind or Have a Disability (MA-ABD) asset rules, or

• MA for Families with Children and Adults with a Medical Spenddown.

Assets that are excluded or unavailable are not counted toward the LTC spouse’s asset limit.

When the LTC spouse has excess countable assets, they must reduce those assets before approval of MA. See EPM 2.3.3.2.6 MA-ABD Excess Assets for more information.

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:

• the LTC spouse assigns the right to support from the community spouse to the Minnesota Department of Human Services (DHS) (this is done by signing the Minnesota Health Care Programs Application for Long-Term Care Services (DHS-3531));

• the LTC spouse is unable to assign the right to support due to a physical or mental impairment; or

• the denial of eligibility would cause an imminent threat to the LTC spouse's health and well-being.

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 nation servicing 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 unless:

• there is a break in MA-LTC for one calendar month or more; and

• the county or tribal nation servicing agency receives a new request for MA-LTC.

 

Legal Citations

United States Code, title 42, Section 1396r-5

Minnesota Statutes 256B.059

Published: September 1, 2022