Prevention of Spousal Impoverishment
If a person is living in a nursing facility, receiving vendor nursing care, or requesting Home and Community-Based Services (HCB), federal law provides a way to protect some of that person’s assets for a spouse. The law also provides for setting aside income, if needed, for a spouse or dependents.
Division of Assets
When a married person enters a nursing facility, a special provision may help protect some of the couple’s resources for the spouse who is not in a nursing facility. This provision also applies when one spouse receives Home and Community-based (HCB) services and the other spouse does not. This spouse is called the "community spouse." This special provision, called "Division of Assets," helps to prevent spousal impoverishment. Anyone who has entered a nursing facility or requested HCB services should ask about a Division of Assets, even if not planning to apply for MO HealthNet coverage in the near future.
Without a Division of Assets, all of a couple’s non-exempt resources would be counted toward the resource limit (see "MO HealthNet for the Aged, Blind, and Disabled,"). A Division of Assets is a way to set aside a certain portion of a married couple’s assets. The portion set aside is called the "spousal share." All assets belonging to either spouse are added together, except for the home they live in, personal belongings, car, or other exempt assets. One-half of the total (but not less than $24,720.00 or more than $120123,600 as of January 2018) is considered as the spousal share for the community spouse. Any portion of a couple’s assets above the spousal share must be considered as available.
If the person does not agree with the amount determined as the "spousal share" or if that person believes the amount needs to be higher to produce sufficient income for the community spouse that should be discussed with the eligibility specialist. However, there is no right to a hearing regarding the spousal share amount until the person actually applies for MO HealthNet coverage for nursing care or HCB services. Once a person applies, a request for an appeal may be made to have the spousal share determination evaluated by an impartial hearing officer.
A Division of Assets by itself does not entitle the person requesting the Division of Assets or the spouse to any cash benefits or medical coverage.
Allotment of Income
If a person is living in a nursing facility, is receiving MO HealthNet, and is approved for Vendor payments, there is a provision that permits setting aside some or all of that person’s income for the community spouse or dependents. In order for this provision to take effect, the community spouse or dependents’ income must be below a certain limit, the Minimum Monthly Maintenance Needs Allowance (MMMNA). In that case, the person in the nursing facility may designate as much of the person’s income as the person wishes as an allotment to the spouse or dependents. However, the allotment may be no more than enough to bring the spouse’s income up to the MMMNA. The amount of the MMMNA varies depending on the individual situation and falls within limits set by law. For a community spouse with no dependents, the MMMNA can vary between $2,030.00 and $3,090.00 as of January 2018.
An allotment from a person in the nursing facility does not entitle the spouse or dependents to any cash benefits or medical benefits from the state.
Who is Eligible?
For a Division of Assets, anyone who:
- is married, and
- is in a nursing facility and expects to remain there for at least 30 days and whose spouse is not in a nursing facility, or who requests HCB services and whose spouse does not want HCB services.
For designating an allotment to a community spouse or dependents, anyone who:
- is in a nursing facility and expects to remain there for at least 30 days;
- is approved for vendor payments
- whose spouse or dependents are not in a nursing facility; and
- whose spouse’s or dependent(s)' income is below their Minimum Monthly Maintenance Needs Allowance (MMMNA).