SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Spousal Impoverishment Budget Calculation

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Spousal Impoverishment Budget Calculation designed to prevent impoverishment of the spouse still living in the community when one spouse needs institutional, waivered services or is enrolled in Managed Long Term Care

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Chronic Care Budget First day of the Month after the month in which A/R is determined to be in Permanent Absence status

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Permanent Absence Status The individual is not expected to return home or is an Institutionalized Spouse

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Institutionalized Spouse Is a person who is: • in a medical institution or nursing facility and is expected to remain for at least 30 consecutive days; or • in receipt of HCBS waivered services and expected to receive such services for at least 30 consecutive days; or • one of the above and expected to receive a combination of institutional and waivered services for at least 30 consecutive days; or • enrolled in MLTC and • married to a person who is not described above

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Community Spouse Resource Allowance (CSRA) State Minimum $74, 820 vs. Federal Maximum $119, 220

SPOUSAL IMPOVERISHMENT Institutionalized Spouse Budget Determining CSRA Mary (CS) Inst. Jan 2010 Dick (IS) Applying 1/14/15 Total current resources are $135, 000 Total combined Countable resources as of Jan 1, 2010 $600, 000 Spousal Share (½ of resources) $300, 000 Max Community Spouse Resource Allowed $119, 220 max $119, 220 vs.

SPOUSAL IMPOVERISHMENT Institutionalized Spouse Budget Determining CSRA Mary (CS) Dick (IS) Inst. Jan 2010 Applying 1/2015 Total Current resources are $90, 000 Total combined Countable resources as of Jan 1, 2010 $600, 000 Spousal Share (½ of resources) $300, 000 vs. $119, 220 max Max Community Spouse Resource Allowed $90, 000

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Minimum Monthly Maintenance Needs Allowance (MMMNA) • Amount allowed for the needs of the community spouse (CS) • $2980. 50 for 2015

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Personal Incidental Allowance (PIA) or Personal Needs Allowance (PNA) • Amount of money the client is allowed to keep to meet personal needs when chronic care budgeting is used • Generally $50

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Personal Incidental Allowance (PIA) or Personal Needs Allowance (PNA) cont’d. Person living in the community and receiving LTHHC, TBI or NHTD services and is an Institutionalized spouse PNA is the difference between the MA level for 2 ($1209) and the MA level for 1 ($825) = $384 PNA for 2015

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Family Member • Minor child; or • Dependent parent or dependent sibling of the IS or CS; and • Must be: • Residing with the community spouse and • Have over 50% of his/her maintenance needs met by the CS and /or IS

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Family Member Allowance (FMA) Formula: 1/3 of the amount by which 1/12 of the 150% FPL for 2 exceeds the amount of otherwise available monthly income of that family member $23, 895 ÷ 12 = $1, 992 ÷ 3 = $664* 150% FPL for 2 FMA for 2015 Each family member can receive up to $664 (*must round up to nearest dollar)

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Family Member Allowance (FMA) How it works: Child in home Income is $250 / month $1, 992 standard FMA level - $250 child’s income $1, 742 ÷ 3 = $581 FMA for Child

SPOUSAL IMPOVERISHMENT SPOUSAL TERMS Family Member Allowance (FMA) How it works: Grandmother in home Income is $500 / month (social security) $1, 992 standard FMA level - $500 grandmother’s income $1, 492 ÷ 3 = $498 Round up to the nearest dollar $489. 00 FMA for Grandmother

SPOUSAL IMPOVERISHMENT Increasing the Community Spouse Resource Allowance for MMMNA Shortfall vs.

SPOUSAL IMPOVERISHMENT Increasing the Community Spouse Resource Allowance CS is a 75 yr old female MMMNA Shortfall is $325/month Excess resource over CSRA is $134, 000 Savings Account Interest Rate Formula: (annual shortfall x 100) ÷ interest rate = additional resource $325 x 12 = $3900 annual shortfall $3900 x 100 = $390, 000 ÷ 3 = $130, 000

SPOUSAL IMPOVERISHMENT Increasing the CSRA Annuity Calculation The amount of the annuity needed to generate $3900 per year income for a 75 year old female is $46, 898 How to obtain cost of an Annuity? http: //www. immediateannuities. com