COMMUNITY SPOUSE RESOURCE ASSESSMENT
Since Arizona is a community property state, all assets are combined when determining if an applicant qualifies under the ALTCS resource guidelines. The CSRA is used to establish the community assets that must be spent before the ALTCS applicant will qualify for medical assistance. Does this mean that if an ALTCS applicant with a community spouse has $500,000.00 in assets, that the applicant can only spend $250,000.00 and qualify for ALTCS?
NO! As with all bureaucratic rules, there are always exceptions.
ALTCS applicants who have a spouse that continues to reside in a community setting (in their own home, assisted living center, adult care home, adult foster care home, or in another setting—but not a nursing home or hospital) have a separate set of rules to determine resource eligibility. One part of those rules includes a CSRA or Community Spouse Resource Assessment.
The first thing that ALTCS does when establishing resource eligibility for community spouse cases is determine the First Continuous Period of Institutionalization (FCPI). ALTCS is looking for the first period (from 9/1/1989 –through the present) that the ALTCS applicant either needed ALTCS services or was in a hospital and/or nursing home for 30 consecutive days. The 30 consecutive days could be any combination of services (home– and community-based services, hospitalizations, nursing facility care, assisted living care, or adult care home) that occurred for 30 consecutive days (without a break of 30 days in-between the different services).
Once ALTCS establishes this date, the eligibility specialist requests verification of the value of all assets owned during that period of time. The reason that ALTCS does this is because it is assumed that the applicant and his/her spouse, more likely than not, owned more assets then, than now. By using this policy, ALTCS is attempting to allow the community spouse to retain a greater share of the community assets. However, even if the assets were not higher at the FCPI, ALTCS will still use those numbers in the calculation.
ALTCS divides the assets in 1/2 and places each half on the appropriate side of the pie (1/2 for the person needing long term care and 1/2 for the spouse). ALTCS then compares the community spouse’s share to the minimum and maximum amounts that ALTCS will allow the community spouse to keep (not spend down to qualify for medical assistance).
If the community spouse’s 1/2 of the assets are above the maximum CSRD (Community Spouse Resource Deduction) $113,640.00*, then the community spouse is only allowed to keep $113,640.00* and the difference must be spent before the applicant will qualify for ALTCS.
If the community spouse’s 1/2 of the assets is between $22,728.00* and $113,640.00*, then the community spouse is allowed to keep his/her half, but the remainder must be spent before the applicant will qualify for ALTCS.
If the community spouse’s 1/2 of the assets are below $22,728.00*, then the community spouse is allowed to keep a minimum of $22,728.00* and the difference must be spent before the applicant will qualify for ALTCS.
Please note that the applicant is still entitled to his/her $2,000.00 resource limit, too. So, add $2,000.00 to the numbers listed above to determine the maximum amount of resources you can have, as a couple, and still qualify for ALTCS.
Help understanding the CSRA and CSRD is only a phone call away!
Call 480/464.4968 or contact us using the form below!
*These numbers are valid from 01/01/2012-12/31/2012.
|
|
|
Community Spouse Income Rules
(the set of rules that ALTCS uses when one spouse is at risk of institutionalization and the other continues to reside in the community)
There are initially two income tests to determine if a community spouse case will income-qualify for ALTCS.
The first test is to add up the countable income of both spouses. Then divide that total by half. If the half is greater than $2094.00*, then the applicant is over income for the program. However, ALTCS completes a second test.
The second test only counts the income of the institutionalized spouse (applicant). If the applicant's income total is less than $2094.00*, then the applicant qualifies. If the income is greater than $2094.00*, then ALTCS will do a third and final test.
The third and final test is to determine if the applicant's income is less than $6481.94*. If it is, the applicant can create and fund an Income-Only Trust (AKA: IOT, or Miller trust) to income qualify for the program.
ALTCS Planning.net can assist the applicant in creating, signing, and funding his/her Income-Only Trust. Our fees are typically 30-75% less than some of our law firm competitors. See our income-only trust page to find out more information about that product.
*The income amounts stated are the income limits for the year 2012.
|
