December 1973 Eligibility Requirements

1030.035.36 COMMUNITY SPOUSE BECOMES INSTITUTIONALIZED

IM-#21, March 3, 2004

Once an institutionalized spouse is determined MO HealthNet eligible the subsequent institutionalization of the community spouse has no effect on the original institutionalized spouse’s eligibility, unless the community spouse applies for MO HealthNet vendor benefits. This policy is based on a Missouri Court of Appeals decision, Maples v. Department of Social Services. When a community spouse enters a MO HealthNet certified Nursing Facility bed, do not deactivate the assessment of assets (refer to¬†1030.035.15.03 DISPOSTION OF ASSESSMENTS) nor count the community spouse’s resources as available to the institutionalized spouse if:

  • the institutionalized spouse has been determined vendor eligible; AND
  • the community spouse does not apply for MO HealthNet vendor benefits.

If the community spouse becomes institutionalized and applies for Medicaid, spousal impoverishment rules no longer apply. Eligibility for both spouses will be determined as a regular couple case.