On May 22, 2024, the Centers for Medicare and Medicaid Services (“CMS”) announced that it would be implementing updated 2024 spousal impoverishment standards that will take effect on July 1, 2024.

The new standards can be found here: https://www.medicaid.gov/federal-policy-guidance/downloads/cib05222024.pdf

As skilled nursing facilities know, the spousal impoverishment standards allow spouses of Medicaid skilled nursing facility residents to keep a portion or all of the marital assets and, in some cases, allow for a portion of the resident’s income to be diverted to the community spouse each month. The specific spousal impoverishment policies vary by state, but CMS determines the limits of how the states can evaluate the couple’s income, assets, and community spouse’s needs. These standards will determine how much of the couple’s combined assets may be kept by the community spouse, how much income may be diverted to the community spouse by the skilled nursing facility resident, and whether the couple’s community residence may be excluded as a countable resource.

Each year, CMS allows for changes to the standards used to determine what amounts a community spouse may keep as “monthly maintenance.”

For 2024, CMS has increased the Minimum Monthly Maintenance Needs Allowance (“MMMNA”) to $2,555.00 (from $2,465.00). Other important changes include:

• A community spouse monthly housing allowance of $766.50 (from $739.50);
• A maximum resource standard of $154,140.00 (from $148,620.00);
• Maximum home equity limits of $1,071,000.00 (from $1,033,000.00).

In evaluating the resource eligibility of the institutionalized spouse, the state Medicaid agency will consider the marital assets as joint assets between the couple regardless of whether the asset is held jointly, or individually by one of the spouses. All assets are added together and the community spouse is permitted to keep half of all countable assets, up to a total of $154,140.00 (under the new standards).

As for income, the community spouse is permitted to keep all of his or her income, half of any income that is considered joint income, and if the total income is less than $2,555.00 (the MMMNA under the new standards), then the community spouse will be able to keep a portion of the resident’s income.

It is notable from our perspective that with the increase in cost-of-living standards across the country and the pressure of inflation, the CMS 2024 spousal impoverishment standards do not seem to keep pace with economic changes (allowing only less than a 4% increase in the standards). Nonetheless, it is important to make note of the changes as they will impact married skilled nursing facility residents’ ability to secure Medicaid.