Institutionalized Spouse or Home and Community Based Services (HCBS) Spouse Asset Limit 510-05-65-15

(Revised 06/01 ML #2590)

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(N.D.A.C. Section 75-02-02.1-24(2))

 

 

  1. An institutionalized or HCBS spouse is allowed the medically needy asset limit of three thousand dollars. The value of any assets owned jointly with the community spouse are considered in full.

  2. An institutionalized or HCBS spouse is asset eligible if the total value of all countable assets, owned by both spouses, is less than the total of the community spouse asset allowance and the institutionalized or HCBS spouse asset limit.

This provision applies to eligibility determinations for all prior months and the month that the application is processed.

  1. After eligibility has been determined, the institutionalized or HCBS spouse must reduce his or her countable assets (solely or jointly owned) to be within the medically needy asset limit ($3,000) not later than the next regularly scheduled redetermination.

If the assets are not reduced to the asset limit by the next regularly scheduled redetermination, the individual's case must be closed. Verification of the reduction in assets must be provided.

 

When an institutionalized or HCBS spouse in an ongoing case exceeds the asset limit, due to an increase in the value of or the receipt of assets, a new period, until the next regularly scheduled redetermination, in which to transfer the excess new assets to the community spouse is allowed. The amount of assets to which this new period applies is an amount equal to the current asset allowance less the value of assets previously transferred to the community spouse. This new period is not allowed if:

  1. The community spouse had assets equal to the community spouse asset allowance at the time the institutionalized or HCBS spouse became eligible; or
  2. The community spouse has since received assets from the institutionalized or HCBS spouse up to the community spouse asset allowance.

The new period begins with the month in which the institutionalized or HCBS spouse exceeds the asset limit. The institutionalized or HCBS spouse's assets must be reduced to the asset limit by the end of the next regularly scheduled redetermination for continued eligibility to exist.

  1. During the continuous period in which the spouse is in an institution or receives HCBS and after the month in which the spouse is determined to be eligible for benefits under this chapter, no countable assets of the community spouse may be deemed available to the institutionalized or HCBS spouse. Assets owned by the community spouse are not considered available to the institutionalized or HCBS spouse during the continuous period; however, a disqualifying transfer of those assets (or of income) by the community spouse will affect the institutionalized or HCBS spouse’s continued eligibility for coverage of nursing care services. See Section 05-80 for more information about the disqualifying transfer provision.

  2. If a spousal impoverishment case closes, or otherwise ceases to include an institutionalized or HCBS spouse and a community spouse, spousal impoverishment provisions no longer apply. If the couple again pursues coverage under the spousal impoverishment provisions, they must meet the current asset limits within the appropriate time frames.