A Six Figure Medicaid Mistake (Part 2)

In my blog post last week I began to tell you about a recent call we received.  A family called seeking help with a Medicaid application for Dad.  The nursing home had filed the application on Dad’s behalf but it had been denied.  

I asked if they had provided Medicaid with 5 years of records for all assets owned by both Dad and Mom.  They told me the nursing home employee said they only needed to provided statements for Dad’s assets.  They were told that providing Mom’s statements was not necessary and “would only complicate things”. 

That was wrong and here’s why.  Medicaid imposes an asset limit.  A Medicaid applicant must be spent down to less than $2000 in assets as of the last day of the month before the first month for which the applicant wants Medicaid benefits.  Additionally, the applicant must remain under $2000 in assets on the last day of each month thereafter in order to maintain Medicaid eligibility.

The family said that Dad met that requirement and that they provided Medicaid with 5 years of statements for the one account that he owned as had been requested by the nursing home employee.  I explained, however, that in the case of a married applicant Medicaid also imposes an asset limit on the non-Medicaid spouse, referred to as the community spouse.

This asset limit is known as the Community Spouse Resource Allowance (CSRA).  So, although Dad has less than $2000, Mom’s assets also will be examined by Medicaid as part of the application process.  5 years of statements must be provided for all these accounts as well.  

So when the nursing home employee told Mom that she did not need to provided these statements she was incorrect and that is the reason the application was denied.  I also told Mom that she has to spend down below a certain number but we need to first determine what that number is. No one had yet done that calculation because Mom had never provided the statements for her assets.

I’ll explain that next week.