The Medicare Catastrophic Coverage Act of 1988 created certain income and resource rules for married couples. These rules are referred to as the Spousal Impoverishment provisions and became effective on October 1, 1989. The purpose of these rules is to allow an individual who is applying for or receiving Medical Assistance Long Term Care (MA/LTC) services to protect a minimum amount of income and resources for the spouse who is not in need of MA/LTC services.
The spouse who is applying for or receiving payment for services in a LTC facility or in a Home and Community-Based Services (HCBS) setting is called the Institutionalized Spouse (IS). The individual who is married to the IS and lives in the community is called the Community Spouse (CS). Spousal Impoverishment provisions apply to married individuals when one spouse receives MA/LTC services in either a LTC facility (for a continuous period of at least 30 days) or in an HCBS setting.
As noted in Section 489.1, all income and resource policy in LTC Handbook chapters 440, Resources and 450, Income, applies to HCBS programs. These two chapters also contain spousal impoverishment policy as it applies to resources and income. In addition to chapters 340 and 350 of the Medical Assistance Handbook, refer to Chapters 440 and 450 when determining eligibility for MA/LTC services provided in a facility or an HCBS setting.
Updated March 19, 2012 , Replacing February 14, 2012