About Spousal Allowance

A Spousal Allowance (SA) is the remaining amount of income that an institutionalized spouse has after deducting the maintenance allowance (part of the patient pay calculation) that will be given to the Community Spouse.  This amount is called the Community Spousal Monthly Income Allowance (M1480.430 D).  VaCMS calculates the SA amount and includes it as part of the Patient Pay calculation.  Click on the Patient Pay tab in Eligibility Summary to view the SA.

The Spousal Allowance is considered countable income for the Community Spouse for Medicaid purposes and may also be considered income for SNAP and TANF.

How to Enter Spousal Allowance as Income for the CS

When there is a Community Spouse and the Institutionalized Spouse intends to give them a Spousal Allowance

1.    Go to the MA Institutionalized Individual screen. 

2.    Choose the question that asks if the Institutionalized individual makes the money available to the Community Spouse and mark “yes”.

a.    If both of the applicants are receiving CBC (Community Based Care), only answer the question for the spouse who will be making part of their money available to the other spouse.

b.    If one spouse is in a Nursing Home and the other is CBC, only answer the question for the Nursing Home spouse.

To determine the correct amount to count as Spousal Allowance income, run eligibility but do not authorize the case.

Click on the Patient Pay tab to view the full Spousal Allowance amount. 

Subtract the Personal Needs amount from the Total Gross Income.  Take note of the remainder balance.  The amount of Spousal Allowance that may be considered countable unearned income to the Community Spouse is either the full Spousal Allowance or the remainder balance, whichever is smaller. Enter that amount as income for the Community Spouse. The effective date will be the month the institutionalized spouse is determined eligible.

1.    Under Income, select Unearned Income.

2.    Choose the Community Spouse’s name and complete the Unearned Income Dates.

3.    Under Unearned Income Type, select Spousal Allowance and enter the amount that is to be counted as income. 

4.    A new required question will ask which program(s) the income should be counted in when determining eligibility. 

5.    Choose from the drop down selection and run eligibility. 

The spousal allowance will only count as income when determining eligibility for the programs you have selected.  It will not count as income for the community spouse when the VaCMS is determining the Spousal Allowance amount each time you run eligibility.

Any time eligibility is run for the case, check to be sure that the Spousal Allowance hasn’t changed.  This amount could change for various reasons such as the Community Spouse’s income changing, rent, or the Utility Standard changes.  If it has, you will need to update the Community Spouse’s unearned income.

Additional Note

If you are not seeing the correct Spousal Allowance amount in the Patient Pay calculation, check to be sure that the rent and utilities are listed under the Community Spouse’s name.

Updated 4/19/19