Community Spouse Allocation (Archive)

Follow the steps outlined in this section to determine the amount to deduct for the community spouse allocation.

Calculating the Community Spouse Allocation.

When Not to Deduct the Community Spouse Allocation from the LTC Income Calculation.

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Calculating the Community Spouse Allocation

Calculate the community spouse allocation as follows:

1. Total the community spouse’s verified gross earned and unearned monthly income, including income from income-producing assets in the community spouse asset allowance.

n  Add all income received less often than monthly and divide by 12 to determine a monthly amount.

n  Do not allow MA disregards or deductions.

n  Do not count Veteran’s Administration Aid and Attendance benefits unless an amount has been apportioned specifically for the community spouse.

2. Determine the community spouse’s verified monthly shelter expenses.

Shelter expenses include:

n  rent.

n  mortgage payments, including principal and interest.

n  real estate taxes.

n  homeowner’s or renter’s insurance.

n  required maintenance charges for a cooperative or condominium.

n  utility allowance.

Note:  Shelter expenses do not include charges for services received by persons in a residential living arrangement Community living arrangements such as group residential housing (GRH), board and lodge, and corporate and foster care settings that provide supportive services. that are not for rent or maintenance charges.

3. Subtract the basic shelter allowance from the community spouse’s monthly shelter expenses (calculated in Step 2 above) to determine the excess shelter expense, if any.

4. Add the minimum monthly income allowance to the excess shelter expense, if any, to determine the community spouse’s monthly maintenance need.

5. Compare the amount calculated in Step 4 above to the maximum monthly income allowance. Use the amount calculated in Step 4 or the maximum monthly income allowance, whichever is less, in Step 6 below.

6. Subtract the community spouse’s gross monthly income (from Step 1) from the community spouse’s monthly maintenance need (amount from Step 5) to determine the community spouse allocation.

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When Not to Deduct the Community Spouse Allocation from the LTC Income Calculation

Deduct the calculated community spouse allocation in the LTC income calculation unless:

l  there is a court order for spousal support for an amount in excess of the calculated community spouse allocation. Deduct the calculated community spouse allocation or the court ordered amount, whichever is greater.  

Note:  This exception only applies to a court order in effect while a couple is still married. This may occur in a legal separation or other court action. Do not deduct a court order for spousal maintenance in a divorce action in the LTC income calculation.

Example:  

Earl resides in an LTCF Long-Term Care Facility. A place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the individual receives skilled nursing services. Group Residential Housing (GRH) and Housing with Services Establishments are not long-term care facilities. and Mary is his community spouse A person who does not reside in a long-term care facility (LTCF) or receive services through a waiver program (EW, CAC, CADI, DD or BI) who is married to a long-term care (LTC) spouse. A community spouse may receive Medical Assistance (MA) or services through the Alternative Care (AC) program.. Mary filed for legal separation from Earl and the court ordered Earl to give her all of his pension money. This amount is greater than the calculated community spouse allocation based on Mary’s shelter costs and income.

Action:

Allocate all of Earl’s pension to Mary according to the court order.  

Example:

Molly resides in a LTCF. She received final divorce papers from her spouse, Tom. The court awarded spousal maintenance of all of Molly’s income to Tom.

Action:

Do not allocate Molly’s income to Tom. There is no longer a community spouse because the couple is divorced. Count Molly’s income when determining her income eligibility.  

l  the LTC spouse does not have enough income left to make the calculated community spouse allocation available to the community spouse. Deduct the amount of income remaining.

Example:

Vera resides in a LTCF and has a community spouse, Jim. Her only income is $636 from RSDI Retirement, Survivors, and Disability Insurance. A program operated by the Social Security Administration that provides a monthly income to retired people, survivors or dependents of insured people, and people with disabilities.. The calculation of the community spouse allowance for Jim results in an unmet need of $750.

Action:

After deducting the $84 clothing and personal needs allowance (PNA) from Vera’s income she only has $552 left to allocate to Jim. Jim’s community spouse allocation is $552.     

l  exceptional or unusual circumstances temporarily warrant a greater amount.

There may be circumstances in which the community spouse allocation is temporarily increased due a financial hardship caused by an exceptional or unusual circumstance. The community spouse must take the necessary steps to resolve the situation.

Example:

Kelsey’s husband, Connor, is in a LTCF. Kelsey’s calculated monthly maintenance needs exceed the maximum monthly income allowance amount by $200. Kelsey’s community spouse asset allowance does not include any liquid assets Cash or other types of assets that can be easily converted to cash, such as bank accounts, stocks, bonds, certificates of deposit, some retirement accounts and money market accounts.. Kelsey is obligated to pay four more months on her lease before she can move into a more affordable living arrangement. Kelsey does not have enough income or assets available to pay the additional $200 she needs to pay for her monthly maintenance needs. Kelsey contacts the worker and indicates she has given notice on the condominium and will be moving to a more affordable apartment when her lease is up.  

Action:

Temporarily increase the community spouse allocation by $200 a month for four months to cover Kelsey’s monthly maintenance needs. Recalculate the community spouse allocation when Kelsey moves to the new apartment taking into account the new rent amount.    

A transfer of income-producing assets from the LTC spouse may be appropriate if the community spouse’s monthly maintenance needs cannot be met with the community spouse allocation at the time the LTC spouse requests MA payment of LTC services.

Do not consider the transfer of income-producing assets if the community spouse’s monthly maintenance needs can be met by first applying the community spouse allocation.

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