Is Medicaid Spousal Refusal an option for me when submitting my spouse’s Medicaid application? In some states, the answer is yes.
Medicaid’s Spousal Refusal (dubbed “Just Say No”) is a strategy utilized in some states to protect a community spouse’s assets while allowing the institutionalized spouse to obtain Medicaid eligibility. Primarily used in New York State, Florida, and Connecticut and formerly used in Illinois, the essence of the spousal refusal is that the healthy spouse will sign a document refusing to support applicant spouse and retain all of the refusing spouse’s assets.
In all cases, the healthy spouse (community spouse) must disclose all of their assets to the state, but under federal Medicaid guidelines, healthy spouses are theoretically able to decline to use their assets to pay for the institutionalized spouse’s care. However, in Illinois, the state has now begun collection actions against the refusing spouse to recover the cost of care.
It should be noted that a married couple’s failure to disclose the exact amount of available resources will result in the denial of long-term care Medicaid coverage for the institutionalized spouse for failure to cooperate.
To prevent spousal impoverishment, the healthy spouse is permitted a monthly maintenance needs allowance, usually consisting of their own monthly income plus a portion of their spouse’s income.
In sum, in the absence of the spousal refusal strategy, it is important to visit an estate planning or elder law attorney to pursue other Medicaid planning strategies and receive legal advice. Medicaid law concerning nursing home care can be complicated, but the staff at QMC are ready to answer your frequently asked questions (FAQs) about your state Medicaid program.