Medi-Cal offers alternatives to nursing homes that also allow the community spouse to keep extra assets and income. Home and Community Based Services (HCBS) are designed for seniors who want to stay at home or within their community and who are at high risk for nursing home placement. Under California law, Spousal Impoverishment protections allow the spouse of the HCBS beneficiary to retain assets, i.e., a community resource allowance (CSRA) of up to $130,380 and income – a maximum monthly maintenance needs allowance (MMMNA) of $3,260. These amounts are adjusted annually by a cost-of-living increase.

When one spouse in a married couple applies for Medi-Cal and indicates on the application that they would like to apply for HCBS, spousal impoverishment protections will be applied upon approval into the program. The HCBS program must work concurrently with the Medi-Cal eligibility worker during the application process to ensure spousal impoverishment is applied.

These programs can be a great alternative to institutionalization and allow access to some couples who would not otherwise be eligible for “community-based” Medi-Cal because of strict asset and income limits; however, the areas of service available are limited by county and sometimes by zip code, and some programs may have waiting lists of up to two years.

To find out more about the program works see our factsheet: http://canhr.org/factsheets/medi-cal_fs/PDFs/ FS_Spousal_Impoverishment_HCBS.pdf