Home CareIn situations where one spouse needs care (i.e., assistance with activities of daily living) at home, it just became easier to obtain Medicaid coverage where the government pays someone to give care at home. Until the law became effective as of October 1, 2015, the couple could have very limited financial resources to be eligible for such Medicaid coverage and countable resources were often “spent down”.  However, as a result of the Affordable Care Act (commonly referred to as “Obamacare”), “spousal impoverishment” protections were extended to the home and community waiver programs (such as Star+Plus in Texas). As a result, if one of the couple’s monthly non-countable resource income (such as Social Security and pension income) is less than $5,179.50, then the resource limit can be expanded.

Current CD interest rates would be used to determine how much countable resources would be allowed. However, since most couples’ non-countable resource income is less than $5,179.50 per month (if one spouse is in a nursing home, the limit for the couple for expansion is $2,980.50 per month), almost everyone with an ill spouse would be entitled to Medicaid coverage (such as the government paying a managed care company to give care for the ill spouse living at home). It should be noted that there is often a waiting list for this program, and it is anticipated that when people become aware of this new rule, the waiting time for coverage could be greatly increased. Furthermore, this spousal impoverishment protection to care for a spouse at home is only effective through December 31, 2018.

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