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Effective: April 1, 2008 |
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23.15ar1 - Determining Community Spouse (Archive) |
Archived: October 1, 2008 |
Not all spouses are considered to be a community spouse. This section provides information on determining if a client is a Long-Term Care (LTC) Spouse or a Community Spouse.
A spouse is a person who is legally married to another person; a husband or wife.
Note: For LTC purposes, this includes a person who is legally separated and not living with their husband or wife regardless of the length of the separation.
For health care program eligibility, marriage must be a union that is legally recognized in Minnesota (as defined in MN State Statute 517.01).
Whether or not an LTC/EW client has a community spouse determines:
l Whether an asset assessment is required.
l The type of income calculation used in determining the LTC/EW client’s eligibility.
l When the LTC income calculation begins or ends.
l Allowable deductions used in the income calculation.
Before determining if a person is a community spouse, first determine if one of the spouses is a LTC Spouse. A person is a LTC spouse if they are married and either:
l Resides in a medical hospital for at least 30 consecutive days.
l Lives in a LTCF and is expected to remain in the facility for at least 30 consecutive days.
l Is expected to receive or receives waivered services through EW for 30 consecutive days beginning on the date the LTCC determines the person requires a long term level of care.
A person must meet the following conditions to be a community spouse:
l Be married to a LTC Spouse.
l Not reside in an LTCF or receive waiver services through EW, CAC, CADI, DD or TBI.
The community spouse may:
l Be eligible for Minnesota Health Care Programs (MHCP), other than being eligible for MA payment of LTC services.
l Receive services through the Alternative Care (AC) program and still qualify as a community spouse.
The following people are not considered a community spouse and do not have a community spouse:
l A person who is not married (single, widowed or divorced).
l A person who lives in an LTCF and their spouse also lives in an LTCF or receives waiver services.
l A person who receives services through EW and their spouse also receives waiver services or lives in an LTCF.