The Medicare Catastrophic Act of 1988 provides Spousal Impoverishment provisions. These provisions provide opportunities for married couples to plan and qualify for Medi-Cal. The spouse is entitled to keep a minimum of $195,000 of non-exempt assets (2023 guidelines). This is commonly referred to as the community spouse resource allowance or CSRA. CSRA combined with a $195,000 property reserve allows the spouse to possess $267,400 of non-exempt assets.
After Medi-Cal qualification and the disabled spouse is moved into a nursing home, his/her name must be removed from all CSRA assets. It is usually advisable to also have his/her name removed from exempt assets, such as the primary residence. The estate planning documents of the disabled spouse must grant the other spouse authority to make gifts or through a court order.
In addition, each state is required by federal law to establish a monthly income floor for the spouse. This is known as the Minimum Monthly Maintenance Needs Allowance (MMMNA). California uses the maximum MMMNA, allowing the spouse to have a minimum monthly income of $3,715.
If the spouse does not have at least $3,715 in income, he/she is allowed to enlarge the CSRA to keep assets over $267,400. This is to generate interest income to compensate. If the increased CSRA is still not enough, the spouse can also take the nursing home spouse’s remaining income to reach the $3,715. This increase in the CSRA can be done through a court order (usually combined with a request to remove the nursing home spouse from all assets).