When a loved one requires long-term care, it can create emotional and financial stress for their spouse, known as the “community spouse.” Medicaid planning provides special asset protections for spouses of Medicaid applicants to ensure the community spouse is not left impoverished while the institutionalized spouse receives the care they need.

What Is the CSRA?

The Community Spouse Resource Allowance (CSRA) is a Medicaid provision that allows the community spouse to retain a portion of the couple’s assets while the institutionalized spouse qualifies for Medicaid. The purpose of this allowance is to prevent spousal impoverishment, ensuring that the community spouse has the financial means to maintain their standard of living.

Each state has specific rules governing the CSRA. Some states have a fixed CSRA amount that the community spouse can protect, while others use a range with a minimum CSRA and a maximum CSRA. The calculation in these states requires a deeper analysis of the couple’s assets.

Determining the CSRA: The Snapshot Date

For Medicaid purposes, the valuation of the couple's assets hinges on the snapshot date—the date on which the institutionalized spouse is first admitted to a medical facility for a continuous period of care of at least 30 days. On this date, all countable assets owned by both spouses are valued to determine how much the community spouse can retain under the CSRA rules.

The CSRA Calculation in States with Minimum and Maximum Limits

In states with a minimum and maximum CSRA, the calculation is as follows:

1. Determine Total Countable Assets: On the snapshot date, combine the value of all countable assets owned by both spouses. This includes bank accounts, investments, and other non-exempt resources.

2. Divide by Two: Split the total asset value in half to determine the community spouse’s share.

3. Compare the Share to State Limits:

   • If the calculated share is less than the state’s minimum CSRA, the community spouse is entitled to protect the minimum CSRA.

   • If the calculated share is greater than the state’s maximum CSRA, the community spouse can protect up to the maximum CSRA.

   • If the calculated share falls between the minimum and maximum CSRA, the community spouse can protect that amount.

     
     

Retaining Less than the CSRA to Avoid Medicaid Delays

It’s often prudent for the community spouse to retain slightly less than the full CSRA amount. Here’s why:

Unintended Oversight: Clients may inadvertently forget to disclose certain assets during the Medicaid planning process. If additional assets are later identified, the community spouse may exceed the CSRA, potentially delaying Medicaid approval.

Buffer for Fluctuations: Leaving a small buffer below the CSRA ensures there is room for adjustments without jeopardizing Medicaid eligibility.

By planning conservatively, the community spouse avoids the risk of inadvertently exceeding Medicaid limits, which could lead to delays in eligibility or penalties.