Doing anything to determine CSRA or it’s sister acronym MMNA monthly maintenance needs assessment/ allowance is not IMO ever a DIY. You needs an experienced Medicaid atty & likely one that is CELA.
The spousal $$$ stuff really gets tied into debt and having debt can actually work in your favor as you’ll need more of the NH spouse mo income diverted or “waived” to you as the still living in the community spouse rather than becoming the NH spouse copay. Like having a hefty mortgage is good rather than paying it off. Having documentation that you as the CS have higher than average prescription drug or utilities or insurance costs, all can work in your favor to get NH spouse income waived to you.
& in looking at CS issues, it’s not just the CSRA or MMNA stuff that matters but the CS income matters too. For the NH spouse thier income is central to getting LTC Medicaid… it has to be within Medicaid limits for your state (most have it abt $2100 mo). But the CS income, should not be a factor for their NH needing spouse to get on Medicaid. The CS income, well that they can be creative with and this is what a savvy CELA type of attorney should be able to give you options to do. Like if you can do a SPIA, single premium immediate annuity.
Personally I hate HATE annuities but a SPIA is a very special creature. The CS is allowed to have thier own exempt assets, tends to be $128k for most states. Over that you go into spend down in order for NH spouse to be Medicaid eligible. But if CS can get a SPIA, they can use the overage to buy a SPIA that pays them a low enough amount. It’s the CS income and not be be an issue for the NH spouse mo income and should not an issue for Medicaid (if your state allows SPIA). So when the likelihood happens that NH spouse dies, the CS still has that nice SPIA out there paying a bit each mo and nothing Medicaid can do about it. SPIA are speciality underwriting and a better elder law atty should know if it makes sense for the CS situation and also have a relationship with underwriter to get one done. You do need to be on the somewhat younger side to make SPIA work best.
Also if it’s NH / CS situation, if your like a lot of married couples you have each other as the beneficiary. Bad idea. So you’ll need to change your beneficiary on life insurance policies before ever doing a Medicaid application. For example, should CS get hit by a bus & die and has the NH spouse as their 50k life insurance beneficiary, it will clusterF the NH spouses Medicaid as the NH spouse now has $ 50k so no longer eligible for Medicaid. Or even a little policy of 10k. Plus The CS spouse is dead, so who is going to do what’s needed for dealing w NH spouse Medicaid paperwork?
It’s stuff like this that makes the NH / CS situation way way more complicated & why you need a good atty to work with ahead of ever doing a Medicaid application. Doing a individual widow or widower Medicaid application is easy compared to CS / NH one IMO.
This all has to do with the combined monthly income you have for one thing. Your assets over and above that income. Basically assets get split with your husbands going towards his care. When spent down then Medicaid is applied for. The Community Spouse remains in the home with one car. You will get enough money to live on. There is more to this. Each state has its own criteria. I suggest consulting with a lawyer well versed in Medicaid.
This is from a site called "Payingforseniorcare.com"
"As mentioned above, Arizona follows a special set of rules to protect the financial security of a non-applicant spouse, when his/her spouse requires long-term care. This means that the state will permit a much higher level of resources to be held by the non-applicant when only one spouse is applying for Medicaid. As of January 2021, this amount may be as much as $130,380. In most states, this is called the Community Spouse Resource Allowance (CSRA), but in Arizona it is called the Community Spouse Resource Deduction (CSRD). Please note that the applicant spouse is still able to keep up to $2,000 in assets. Should one have more assets than the allowable limit, it is possible to convert countable assets into exempt ones, such as using funds to modify one’s home to be wheelchair accessible. By doing so, a person can lower their countable assets, and hence, meet Medicaid’s asset limit. This option is most likely to help those who are close to the limits and still cannot afford their cost of care. To consider how to restructure your financial assets, one should consult with a Medicaid planner. Simple errors can delay benefits and may disqualify an applicant from Medicaid."
With regard to income, the site states:
"Arizona follows a special set of rules to protect the financial security of a healthy spouse, also called the community spouse, well spouse, or non-applicant spouse, when his or her spouse needs long-term care. This means that the state will permit an applicant spouse to transfer income to a non-applicant spouse. This is commonly called a monthly maintenance needs allowance, but in Arizona, it is called a community spouse monthly income allowance (CSMIA). This spousal allowance protects the non-applicant spouse from having too little income from which to live. As of 2021, an applicant spouse may transfer up to $3,259.50 / month in income to his/her non-applicant spouse in order to bring his/her monthly income to this level. It is still possible to qualify for ALTCS with income over the limit should the excess income be allocated to an income only trust, also called a Miller Trust. In Arizona, this type of trust is often called a Special Treatment Trust (STT). To learn more about Medicaid qualifying income trusts, one should contact a planning professional familiar with Arizona Medicaid."
The spousal $$$ stuff really gets tied into debt and having debt can actually work in your favor as you’ll need more of the NH spouse mo income diverted or “waived” to you as the still living in the community spouse rather than becoming the NH spouse copay. Like having a hefty mortgage is good rather than paying it off. Having documentation that you as the CS have higher than average prescription drug or utilities or insurance costs, all can work in your favor to get NH spouse income waived to you.
& in looking at CS issues, it’s not just the CSRA or MMNA stuff that matters but the CS income matters too. For the NH spouse thier income is central to getting LTC Medicaid… it has to be within Medicaid limits for your state (most have it abt $2100 mo). But the CS income, should not be a factor for their NH needing spouse to get on Medicaid. The CS income, well that they can be creative with and this is what a savvy CELA type of attorney should be able to give you options to do. Like if you can do a SPIA, single premium immediate annuity.
Personally I hate HATE annuities but a SPIA is a very special creature. The CS is allowed to have thier own exempt assets, tends to be $128k for most states. Over that you go into spend down in order for NH spouse to be Medicaid eligible. But if CS can get a SPIA, they can use the overage to buy a SPIA that pays them a low enough amount. It’s the CS income and not be be an issue for the NH spouse mo income and should not an issue for Medicaid (if your state allows SPIA). So when the likelihood happens that NH spouse dies, the CS still has that nice SPIA out there paying a bit each mo and nothing Medicaid can do about it. SPIA are speciality underwriting and a better elder law atty should know if it makes sense for the CS situation and also have a relationship with underwriter to get one done. You do need to be on the somewhat younger side to make SPIA work best.
Also if it’s NH / CS situation, if your like a lot of married couples you have each other as the beneficiary. Bad idea. So you’ll need to change your beneficiary on life insurance policies before ever doing a Medicaid application. For example, should CS get hit by a bus & die and has the NH spouse as their 50k life insurance beneficiary, it will clusterF the NH spouses Medicaid as the NH spouse now has $ 50k so no longer eligible for Medicaid. Or even a little policy of 10k. Plus The CS spouse is dead, so who is going to do what’s needed for dealing w NH spouse Medicaid paperwork?
It’s stuff like this that makes the NH / CS situation way way more complicated & why you need a good atty to work with ahead of ever doing a Medicaid application. Doing a individual widow or widower Medicaid application is easy compared to CS / NH one IMO.
"As mentioned above, Arizona follows a special set of rules to protect the financial security of a non-applicant spouse, when his/her spouse requires long-term care. This means that the state will permit a much higher level of resources to be held by the non-applicant when only one spouse is applying for Medicaid. As of January 2021, this amount may be as much as $130,380. In most states, this is called the Community Spouse Resource Allowance (CSRA), but in Arizona it is called the Community Spouse Resource Deduction (CSRD). Please note that the applicant spouse is still able to keep up to $2,000 in assets.
Should one have more assets than the allowable limit, it is possible to convert countable assets into exempt ones, such as using funds to modify one’s home to be wheelchair accessible. By doing so, a person can lower their countable assets, and hence, meet Medicaid’s asset limit. This option is most likely to help those who are close to the limits and still cannot afford their cost of care. To consider how to restructure your financial assets, one should consult with a Medicaid planner. Simple errors can delay benefits and may disqualify an applicant from Medicaid."
With regard to income, the site states:
"Arizona follows a special set of rules to protect the financial security of a healthy spouse, also called the community spouse, well spouse, or non-applicant spouse, when his or her spouse needs long-term care. This means that the state will permit an applicant spouse to transfer income to a non-applicant spouse. This is commonly called a monthly maintenance needs allowance, but in Arizona, it is called a community spouse monthly income allowance (CSMIA). This spousal allowance protects the non-applicant spouse from having too little income from which to live. As of 2021, an applicant spouse may transfer up to $3,259.50 / month in income to his/her non-applicant spouse in order to bring his/her monthly income to this level.
It is still possible to qualify for ALTCS with income over the limit should the excess income be allocated to an income only trust, also called a Miller Trust. In Arizona, this type of trust is often called a Special Treatment Trust (STT). To learn more about Medicaid qualifying income trusts, one should contact a planning professional familiar with Arizona Medicaid."
Here is a link to another useful site:
https://www.medicaidplanningassistance.org/medicaid-eligibility-arizona/