Medicaid’s “Snapshot” Date

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 called the “snapshot” date and it can have a major impact on a couple’s financial future.

Medicaid Eligibility

In order to be eligible for Medicaid benefits a person in need of home and community based long term care benefits or nursing home care may have no more than $2,000 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.

Community Spouse Resource Allowance (CSRA)

In general, the community spouse may keep one-half of the couple’s total “countable” assets up to a maximum of $148,620 (in 2023). This is the community spouse resource allowance (CSRA), the most that Indiana may allow a community spouse to retain without a hearing or a court order. The least that Indiana may allow a community spouse to retain is $29,724 (in 2023).

This “community spouse resource allowance” (CSRA) adjusts each year. It is the maximum amount a state may allow the healthy spouse to retain (without a hearing or a court order). The least that a state may allow a community spouse to retain is $29,724 (in 2023).

For instance, a couple has $100,000 in countable assets on the date the applicant enters a nursing home. The applicant will be eligible for Medicaid once the couple has reduced their assets to a combined figure of $52,000. (That is, $2,000 for the applicant and $50,000 for the community spouse).

Some states, however, are more generous toward the community spouse. In these states, the community spouse may keep up to $148,620 (in 2023) whether or not this represents half the couple’s assets.

So, if a couple had $100,000 in countable assets on the “snapshot” date, the community spouse could keep the entire amount. They would not have to limit their assets to half the amount ($50,000).

What is a “Snapshot” Date?

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 is usually the date of “institutionalization,” 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.  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, assisted living, or adult day 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 (determined by the Area Aging Agency).

Income and Eligibility

Fortunately, Medicaid does not count the income of the community spouse in determining the Medicaid applicant’s eligibility. It only counts the income in the applicant’s name.

Imagine a community spouse who still works and earns, say, $5,000 a month. They won’t have to contribute toward the costs of care for their spouse who has Medicaid coverage in a nursing home.

In some states, however, the community spouse’s income cannot exceed certain levels. If it does, they do have to contribute toward the care cost for their spouse in long-term care. In these states, the community spouse’s income is not part of the equation when Medicaid is determining eligibility. Yet the community spouse may still be subject to a contribution requirement.

Minimum Monthly Maintenance Needs Allowance (MMMNA)

There are cases where most of the couple’s income is in the Medicaid applicant’s name. As a result, the community spouse may not have enough income to continue living on their own. In such cases, the community spouse can in fact keep some or all of their nursing home spouse’s monthly income.

The amount of income the community spouse can retain depends on the Medicaid agency. State Medicaid agencies determine the minimum income level – or minimum monthly maintenance needs allowance (MMMNA) – for the community spouse. The Medicaid agency uses a complicated formula to calculate this allowance for community spouses, based on their housing costs.

The MMMNA may range from a low of $2,288.75 to a high of $3,715.50 a month (in 2023). If the community spouse’s own income falls below their MMMNA, the nursing home spouse’s income covers the shortfall.

For example, Jason Smith and his wife, Samantha Brown, have a joint income of $3,000 a month. Mr. Smith has $1,700 in his name, while Ms. Brown has $700 in her name.

Mr. Smith enters a nursing home and applies for Medicaid. The Medicaid agency determines that Ms. Brown’s MMMNA is $2,300 (based on her housing costs). The Medicaid agency allocates $1,500 of Mr. Smith’s income to support her, since her own monthly income totals only $700.

Mr. Smith also may keep a $60-a-month personal needs allowance. So, his obligation to pay the nursing home is only $140 a month ($1,700 – $1,500 – $60 = $140).

In exceptional circumstances, community spouses may seek an increase in their MMMNA. They can either appeal to the state Medicaid agency or obtain a court order of spousal support.

What Assets are Counted on the Snapshot Date?

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. Then the agency determines how much the community spouse can keep. If any assets above $2,000 remain, then that money must be spent down or sheltered in legal safe harbors (i.e. exempt assets) before the applicant will qualify for benefits.

  • Example: If a couple has $100,000 in countable assets on the snapshot date and the state allows the spouse to keep half the couple’s assets up to the maximum CSRA, the Medicaid applicant will be eligible for Medicaid once the couple’s assets have been reduced to a combined figure of $52,000 — $2,000 for the applicant and $50,000 for the community spouse.

Applying for Benefits Based on the Snapshot Date

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. Contact the Stinson Law Firm at 317-622-8181 to protect marital assets for the community spouse and help the spouse in need of services obtain valuable long term care coverage.

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