Community Spouse's Resource Allowance (CSRA)/Medicaid
The CSRA is an amount of resources that states must protect for the spouse of an institutionalized person seeking Medicaid coverage. It is determined by application of a formula, or, as explained below, through a fair hearing, or by court order. The CSRA may not be counted in determining the eligibility of an individual seeking Medicaid.
The CSRA is determined as follows:
(1) All nonexempt resources belonging to either member of the married couple will be pooled together regardless of who owns them, and regardless of marital property laws (e.g., equitable distribution laws, community property laws).
(2) The community spouse is entitled to an amount (community resource allowance), subject to paragraph 3 below, equal to the greater of:
- $19,824 (2000), as adjusted annually for inflation, or more, if a greater minimum amount is set by the state, or
- one-half the total resources of the couple to a maximum of $16,824 (2000), as adjusted annually for inflation.
(3) A state may establish a dollar amount which is both the minimum and maximum resource amount. Under the foregoing formula, $84,120 represents a maximum and $16,392 represents a minimum on the CSRA. A state, by opting to use the maximum resource amount, can establish $84,120 as both a maximum and minimum. A state may opt to select a spousal share amount which, in the alternative, is that sum (e.g., New York, $74,820) or a greater figure equal to one-half of the couple's resources, but not to exceed the maximum figure of $84,120.
(4) The CSRA amount is determined according to resources owned by the couple on the first day of a continuous period of institutionalization regardless of whether the institutionalized spouse applied for Medicaid at the time. (See also Snapshot rule/Medicaid.) Either spouse may ask the Medicaid agency to complete an assessment of their resources as of that time. The CSRA can be increased above the formula amount in two ways:
- Either spouse can request a fair hearing in which to demonstrate that a larger amount of resources must be protected (i.e., transferred to the community spouse from the institutionalized spouse) to generate income needed to bring the community spouse's income up to the minimum monthly maintenance needs allowance.
- A court order granting a larger amount of resources for the community spouse; the order must be honored by the Medicaid agency.
