Community Spouse Resource Allowance

The Community Spouse Resource Allowance (CSRA) is the amount of resources the spouse who stays home (called the "Community Spouse" in Medicaid lingo) is allowed to keep without being subject to further spend-down. Even at its most generous level, it's a meager amount of resources to sustain the Community Spouse.

How is CSRA calculated?

Medicaid takes a financial picture (commonly called the "Snapshot Date") of what the married couple owns on the first date the spouse asking for care (called the "Institutionalized Spouse" in Medicaid lingo) goes into a facility for 30 or more days or simply asks for Medicaid Benefits.

Once Medicaid knows what the assets are for the Snapshot Date, it simply divides all the resources not subject to exemption (called "countable resources") in half. But that's not the end of the analysis. Medicaid has a maximum CSRA it allows—$123,600 as of 2018. It also has a minimum CSRA—$24,720 as of 2018.

What if the couple has $180,000 of countable resources?

The CSRA is $90,000 and the spend-down is $88,000 (the Institutionalized Spouse is allowed to have up to $2,000 which can be given to the Community Spouse).

What if the couple has $40,000 of countable resources?

This is a "minimum" CSRA case where the Community Spouse gets to keep $24,720 and the spend-down is $13,280. Again, the Institutionalized Spouse gets to keep $2,000.

What if the couple has $800,000 of countable resources?

This is a "maximum" CSRA case where Community Spouse gets to keep $123,600 and the spend-down is $674,400 with the $2,000 being kept for the Institutionalized Spouse. As you can see, if you have money and savings, Medicaid expects you to spend a lot of it before it'll provide benefits. Eligibility only begins after the Community Spouse has no more than the CSRA and the Institutionalized Spouse's $2,000.

What happens if the couple doesn't like the CSRA and spend-down?

That's where we have to be creative and use the rules to the couple's advantage. Medicaid "wants" them to generally use the spend-down on the spouse's care. But they don't "require" it. There are ways to keep all of the spend-down amount from being spent on care. To do that, they need to have a strategy and a plan. That's where we come in—we help figure out that plan and then implement it.