Medicaid Policy
Medicaid Policy
Contact DHHS Policy Specialist for Previous Policy (373-1 renumbered to 573-1 as of November 1, 2017)
Apply the rules in section 573-1 when:
the individual’s entry into a medical institution was after September 30, 1989, and
the individual is in a medical institution or nursing facility, and
the individual is expected to stay for at least 30 consecutive days, and
The individual is married to a spouse who is not in a medical institution or receiving waiver Medicaid.
The assessment is the process of dividing the couple's resources allowing each one half.
Complete an assessment of assets when:
An institutionalized spouse or the community spouse requests an assessment of assets, or
When an institutionalized spouse applies for Medicaid and has not had an assessment.
Complete the assessment once. Use assets owned by either or both spouses on the date the individual entered a medical institution (215-4) the first time for a continuous stay of 30 days or more.
Follow the asset policy in section 500 to determine availability of assets, value of assets, what assets are counted or to what extent assets are counted, etc.
If both spouses are in an institution or on a waiver at the same time, but one member returns to the community or stops being eligible under a waiver, do an assessment as of the date the spouse who is still in the institution or on a waiver entered the institution or waiver for the first time.
An assessment conducted by a Medicaid agency in another state is valid.
The community spouse's assessed share is one half of the total countable assets owned by the institutionalized and community spouse as of the beginning of the first continuous period of institutionalization. [NOTE: The spousal share is a set amount that does not change regardless of what happens to the resources. However, the amount of resources protected for the community spouse may not be the same as the spousal share because of how the minimum and maximum resource rules apply.]