Spousal Inheritance Disqualify Other Spouse for Medicaid

No, a significant inheritance by the community spouse will not cause the institutionalized spouse to lose their Medicaid benefits. This answer is given with the assumption that the institutionalized spouse has already gone through Medicaid’s application process and has been approved for long-term care benefits.

To further explain, a definition of community spouse and institutionalized spouse can be helpful.

-Community Spouse – the non-applicant spouse of an applicant / beneficiary of Nursing Home Medicaid or long-term care services via a Home and Community Based Services (HCBS) Medicaid Waiver.

-Institutionalized Spouse – the applicant / beneficiary spouse of Nursing Home Medicaid or home and community based services via a Medicaid Waiver. The term, institutionalized is a bit misleading since persons receiving waiver services are able to reside at home, or in some states, an adult foster care home or an assisted living residence. It is also beneficial to discuss how Medicaid looks at the income and assets of the applicant and non-applicant spouse during the Medicaid application process.

-Income – when one spouse of a married couple is applying for long-term care Medicaid, and the other spouse is not, only the income of the applicant spouse is considered. Even if the non-applicant spouse has a significant amount of monthly income, it will not impact the income-eligibility of the applicant spouse. Not relevant to this conversation, but relevant to how Medicaid considers the income of a married couple with only one applicant is a Monthly Maintenance Needs Allowance. When a non-applicant spouse has little to no monthly income, the applicant spouse is able to transfer monthly income in their name to their spouse.

-Assets – unlike with income, assets are considered jointly owned by the couple. All of the couple’s countable assets (assets that are not exempt from Medicaid’s asset limit) are added together to get a total value. Generally speaking, an applicant spouse is able to retain up to $2,000 in countable assets, and the non-applicant spouse is allocated a larger portion of the assets as a Community Spouse Resource Allowance. See state-specific asset limits.

If the community spouse (the non-applicant spouse) receives a significant inheritance, or even a small inheritance, prior to the applicant spouse being approved for long-term care Medicaid benefits, the Medicaid applicant may not be eligible for Medicaid. The inheritance might push the couple’s assets over Medicaid’s allotted limit for the applicant spouse and the non-applicant spouse. If a couple has assets over the limit, the applicant spouse can still qualify for Medicaid benefits after “spending down” the excess assets (the assets over the limit).

If a community spouse is the recipient of a significant inheritance after the applicant spouse has been deemed eligible for Medicaid benefits, the institutionalized spouse (the Medicaid beneficiary) will not become ineligible for Medicaid. In other words, the Medicaid beneficiary will continue to receive their Medicaid benefits.