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Community Spouses Can Keep More Income

Written By: Attorney Jeffrey A. Marshall, CELA* 

Originally published in the Lock Haven Express & Hazleton Panorama (June 2006)

Usually, a nursing home resident who is on Medicaid is required to pay most of their income to help pay for the cost of the nursing home care.  However, federal law provides some financial protections for married couples when one of them enters a nursing home. 

A low income community spouse may be allowed to receive some of the institutional spouse's income. The amount of this income allowance is dependent on state law and the income and housing expenses of the community spouse.

In Pennsylvania , the minimum income allowance is set at 150 percent of the federal poverty level for a family of two plus an excess shelter allowance. The excess shelter allowance is the amount by which certain housing-related expenses of the community spouse exceeds the standard shelter allowance that is built into the minimum. 

If the income of the community spouse is not sufficient to yield income equal to or above the required allowance, the amount of the shortfall is diverted to the community spouse from the income of the institutionalized spouse. This additional support is called the "community spouse monthly income allowance" (CSMIA).

The community spouse income allowance is subject to a ceiling and a floor.  The ceiling which is adjusted each January 1^st is $2,488.50. The floor, or base amount, is adjusted each July 1^st. On July 1, 2006 it will increase from $1,604 a month to $1,650 per month.

In addition to any amount of support paid to the community spouse, a nursing home resident on Medicaid is allowed to keep a personal needs allowance (currently $40 per month) and enough income to pay medical expenses that are not covered by Medicaid. Once these items are deducted from the institutionalized spouse's income, any remaining income is contributed toward the cost of his or her care in the institution.

Jeff Marshall is Certified as an Elder Law Attorney by the National Elder Law Foundation and is the author of Elder Law in Pennsylvania. He is the managing attorney of the Elder Law Firm of Marshall & Associates with offices in Jersey Shore, Williamsport and Wilkes-Barre..  He can be contacted at webmail@paelderlaw.com.

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