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Thursday, July 23, 2015

Understanding Medicaid Eligibility Rights for Same-Sex Spouses

Now that same-sex marriage is a fundamental right in all 50 states, how will Medicaid eligibility change to ensure same-sex spouses are afforded the same allowances and exclusions? 


Qualifying for Medicaid is often a vital milestone for those in need of long-term care, and generally requires a drastic spend-down of assets in order to meet financial eligibility regulations. Generally speaking, married couples tend to fare better overall when it comes to reducing assets, as the spouse able to remain in the community (known as the “community spouse”) is allowed to continue living in the marital home and receive a modest monthly income. For unmarried same-sex couples, this left them in a predicament in terms of calculating separate assets if they were living in a state that did not recognize same-sex marriage as valid. Now, as all same-sex couples are able to marry – and same-sex marriages are recognized as valid in all jurisdictions – applying and qualifying for Medicaid may take same-sex couples on a new path toward eligibility. 

Benefits of Medicaid eligibility for spouses

Medicaid’s financial thresholds were created with the dual-interest of not only ensuring the beneficiary has exhausted his or her own personal assets before receiving assistance, but also avoiding unnecessary impoverishment of the community spouse. For instance, 2015 guidelines allow the community spouse to maintain $119,000 in assets – a protection not previously afforded to same-sex couples in an unrecognized union. Likewise, state Medicaid authorities cannot initiate a Medicaid lien on a beneficiary’s home if his or her spouse still lives there – another new benefit for spouses. 

Another major benefit now enjoyed by same-sex spouses is that one may transfer assets to the other without triggering a penalty during the look-back period. Before, a transfer between same-sex spouses residing in a jurisdiction that did not recognize same-sex marriage was treated as a general asset allocation similar to a parent-child transfer. Now, same-sex couples can enjoy the same rights to keep their assets in hand as applicants in a traditional marriage. 

If you are considering applying for long-term care benefits, or you would like to speak to a reputable estate planning attorney for additional information, please contact the Law Offices of Berge & Berge, serving the areas of San Jose and Santa Clara County, California, today: (408)985-9918. 

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