When a married couple applies for Medicaid, the Medicaid agency must analyze the couple’s income and assets as of a particular date to determine eligibility. The date that the agency chooses for this analysis is sometimes referred to as the “snapshot” date and it can have a major impact on a couple’s financial future.
In order to be eligible for Medicaid benefits in New York a nursing home resident may have no more than $16,800 in “countable” assets. Medicaid law also provides special protections for the spouses of Medicaid applicants to make sure they have the minimum support needed to continue living in the community while their husband or wife is receiving long-term care benefits.
In New York (in 2022), the community spouse may keep the greater of $74,820 or one-half of the couple’s total “countable” assets” (“the spousal share”) up to a maximum of $137,400. This is the “community spouse resource allowance” (CSRA), the most that a state may allow a community spouse to retain without a hearing or a court order.
Medicaid agencies must pick a date to use to analyze the applicant’s assets. The date that the agency chooses can affect how much money the applicant must spend down before qualifying for benefits and how much a spouse is able to keep. It is called the “snapshot” date because Medicaid is taking a picture of the applicant’s assets as of this date.
The snapshot date in New York is usually as of the beginning of the first period of continuous institutionalization. The date of “institutionalization,” being the day on which the Medicaid applicant enters either a hospital or a long-term care facility in which he or she then stays for at least 30 consecutive days. The Medicaid agency may use as the snapshot date either the first day of the month the applicant entered the facility or the actual date of entry. If the applicant enters a hospital or nursing home, stays for 30 days, goes home, and then reenters a hospital or nursing home, the snapshot date is the date the applicant entered the hospital or nursing home for the first stay.
Not all Medicaid long-term care applicants are in an institution. If the applicant is applying for Medicaid home care through a waiver program, the snapshot date is usually either the date of the application or the date the applicant is determined to need a nursing home level of care.
On the snapshot date, the Medicaid agency counts up all of an applicant’s and his or her spouse’s assets, excluding the couple’s house and other exempt resources. Then the agency determines the “spousal share” which is how much the community spouse can keep. If any assets above $16,800 remain, then that money must be spent down before the applicant will qualify for benefits.
Example: If a couple in New York in 2022 has $150,000 in countable assets on the snapshot date, the community spouse is allowed to retain the greater of $74,820 or one half of the couple’s nonexempt or “countable” assets up to a maximum of $137,400. Therefore, the couple could maintain a personal resource account for the Institutionalized spouse up to $16,800 and the community spouse would be able to retain the remaining $133,200. Additionally, there may be reason for the community spouse to maintain an increased spousal share depending on the specific facts.
Proper planning can help a couple determine when the best time to apply for benefits based on the snapshot date and maximize the assets the couple can keep. Consult with your attorney for advice.