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Community
Spouse Resource Allowance (CSRA): The
Community Spouse Resource Allowance
is the amount that the Medicaid regulations permit the spouse staying
at home to retain. To
calculate the CSRA, divide the total countable assets by 2. There
is a maximum CSRA of $89,250 and a minimum
of $17,856. All other assets
must be spent down prior to Medicaid
eligibility.
Community
Spouse: The
Community Spouse is the spouse in the spouse remaining in the
community.
DMAHS:
This stands for the Division of Medical Assistance and Health
Services. It is
the State Medicaid Agency.
Institutional
Spouse: The
Institutional Spouse is the spouse in the person in a nursing home
or receiving an institutional level of care under a home care program.
Lookback:
Medicaid uses the term lookback.
It is a period of time beginning from the
date of the Medicaid Application back.
In the case of an individual, the
lookback is three (3) years and in the case of a trust the lookback is
five (5)
years. If transfers or gifts
are made during the lookback period, they
are penalized.
Medicaid
Only: Medicaid Only is a Medicaid Program in New Jersey which
is limited to persons
having an income of $1635 a month or less.
Medicaid Only covers
nursing homes, home care and adult day care programs.
Medicaid:
Medicaid is a medical assistance program funded by the Federal and State
Governments.
It is administered by the states.
Medically
Needy: Medically Needy is another Medicaid Program in New
Jersey that in the
long-term care arena covers only nursing homes. It does not cover assisted
living, home care or adult day care.
Minimum
Monthly Maintenance Needs Allowance (MMMNA):
Medicaid permits the community
spouse to retain a certain portion of the institutionalized spouse's
income to bring the community spouse's income up the minimum
monthly maintenance needs allowance.
This is calculated at $1,452
per month minus the community spouse's other income. In addition
there is an excess shelter allowance if certain shelter expenses exceed
$436 per month.
Non-Countable
Assets: Certain assets
are non-countable for Medicaid eligibility purposes.
These include a home if occupied by certain members of a protected
class. An automobile under
certain conditions, personal effects, engagement
rings, wedding rings, and household goods.
Penalty:
A Medicaid penalty is a period of ineligibility for Medicaid.
It is based on the
uncompensated value of assets transferred.
The more assets that are transferred
the longer the period of ineligibility or penalty will be.
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