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Revision 10-2; Effective June 1, 2010
For the resource eligibility test, combined treatment of resources is required by federal regulations. In determining the resources of an institutionalized spouse, regardless of any state laws relating to community property or the division of marital resources, all the resources held by either the institutionalized spouse, community spouse or both shall be considered to be available to the institutionalized spouse.
When totaling countable resources for the institutional spouse consider the total value of the resources to the extent either the institutionalized spouse or the community spouse has an ownership interest.
Use Chapter F, Resources, for treatment of resources to determine countable value. Apply exclusions, as appropriate, keeping in mind the federal requirement to use the combined resources regardless of any state laws relating to community property or the division of marital resources.
For the assessment and the initial eligibility period, follow these exceptions to the resource exclusions in Chapter F and do not consider in the countable value the following resources:
- one automobile; and
- a home, if:
- the community spouse or dependent family member continues to live in the home while the person is in the institutional setting;
- the community spouse lives in another state on out-of-state property, whether or not the institutionalized spouse has ownership interest; or
- the community spouse had been living in the out-of-state property as a home but is not residing there during the assessment and initial eligibility period and the community spouse signs a statement of intent to return to the home.
- household goods and personal effects (see Section F-4222, Household Goods and Personal Effects).
Determine countable resources based on resources of the couple beginning with the first month for which eligibility is being tested (including prior months). Follow standard resource requirements to verify the resources as of 12:01 a.m. on the first day of the month.
Countable resources can be reduced by the amount of funds encumbered before 12:01 a.m. on the first day of the month by any checks written before that time that have not yet been processed by the financial institution. For further information about encumbered funds, see Section F-1311, Encumbered Funds, and Section F-1312, Nursing Facility Refunds.
At application, resource eligibility will be determined from the countable resource. See Section J-5000, Spousal Initial Application.
J-2210 Out-of-State Home and Spousal Impoverishment
Revision 09-4; Effective December 1, 2009
With the following exceptions, a person who applies for and receives Medicaid benefits in Texas is not allowed to exclude a home in another state. Otherwise, if the person considers his home in another state to be his principal place of residence, he is not a Texas resident, and he must apply for assistance in his home state.
- If the community spouse lives in another state in a house that the institutional spouse claims is not his homestead, to determine the protected resource amount and initial eligibility, exclude the out-of-state property as a part of resources totally excluded regardless of value. If the institutional spouse still has an ownership interest in the property at the first annual redetermination, HHSC considers the value of the property a countable resource that is real property. This situation does not affect residency requirements. As long as the institutionalized spouse intends to remain in the state where he is institutionalized, he is considered a resident.
- If the community spouse lives in another state in a house that is the institutional spouse’s homestead, the home is excluded in the resource assessment and throughout the initial eligibility period of 12 months. If the institutional spouse still has an ownership interest in the property at the first annual redetermination, the home is a countable resource. If the community spouse is not living in the out-of-state home, the community spouse must sign a statement of intent to return for the home to be excluded for the resource assessment and initial eligibility period of 12 months.
See Section F-3000, Home, and Section F-3500, Out-of-State Home Property.