Nebraska Spousal Impoverishment Rules: How Much Can the Community Spouse Keep?

Understanding Spousal Protections in Nebraska

When a husband or wife requires long-term nursing home care in Nebraska, the monthly cost can easily exceed $8,000 to $10,000. For most couples in Omaha, Lincoln, or Kearney, these massive bills can wipe out a lifetime of savings in just a few years. A common fear is that the healthy spouse (legally called the community spouse) will be left penniless and unable to afford food, housing, or basic medical care.

Fortunately, federal law and Neb. Rev. Stat. § 68-901 establish strong Spousal Impoverishment protections. These rules ensure that the community spouse is allowed to keep a specific amount of assets and monthly income while still allowing the sick spouse to qualify for Medicaid coverage. Navigating these complex financial thresholds can be overwhelming, so finding a specialized elder law attorney in our US Lawyer Directory is highly recommended to protect your financial security.

How the Rules Work in Practice

Medicaid treats married couples as a single financial unit. When applying, the Nebraska Department of Health and Human Services, Lincoln takes a snapshot of all combined assets, regardless of whose name is on the bank account.

Step 1: Calculating the Community Spouse Resource Allowance (CSRA)

The CSRA is the amount of cash, investments, and property the healthy spouse is legally allowed to keep. In Nebraska, the community spouse is generally allowed to keep 50% of the couple's countable assets, up to a federal maximum limit. Even if 50% is a very small number, Nebraska enforces a minimum guaranteed floor, ensuring the healthy spouse is never left with nothing. Important exempt assets, like your primary residence, a vehicle, and personal belongings, do not count toward this limit.

Step 2: Securing the Minimum Monthly Maintenance Needs Allowance (MMMNA)

Assets are just one piece of the puzzle; income is the other. The MMMNA is designed to ensure the healthy spouse has enough monthly cash flow to pay their living expenses. If the healthy spouse's personal income (like their own Social Security or pension) falls below Nebraska's minimum threshold, the law allows them to keep a portion of the institutionalized spouse's income. This process shifts income away from the nursing home and directly into the healthy spouse's bank account.

Step 3: Appealing for a Higher CSRA Through a Fair Hearing

What if the standard CSRA is not enough to generate the income you need to survive? If your living expenses are exceptionally high due to a mortgage or your own medical bills, you can appeal. You must file Form DA-6, Nebraska, Department of Health and Human Services, Request for Fair Hearing / Appeal. During this hearing, your attorney can argue before a judge that your CSRA should be increased beyond the standard maximum limits. A notable case, Wisconsin Dept. of Health and Family Services v. Blumer, 534 U.S. 473 (US Supreme Court 2002), illustrates how courts carefully evaluate spousal assets and Medicaid claims.

Step 4: Protections for Non-Applicant Spouses in Assisted Living

Spousal impoverishment rules generally apply when one spouse is in a skilled nursing facility and the other is at home. However, if the community spouse lives in an assisted living facility or an independent living apartment in Bellevue or Papillion, the rules can get complicated. Room and board costs at an assisted living facility can sometimes be factored into the MMMNA calculation to help justify shifting more of the sick spouse's income to the healthy spouse to cover those high housing costs.

How Much Does Medicaid Planning Cost?

Investing in legal help to maximize your CSRA and MMMNA can save you tens of thousands of dollars:

• Consultation and Financial Snapshot: An elder law attorney typically charges $300 to $500 to assess your combined assets and income.
• Medicaid Application Preparation: A comprehensive service to organize finances and file the application usually ranges from $4,500 to $8,500.
• Fair Hearing Representation: If you must go to a hearing to fight for a higher allowance, lawyer fees generally add an additional $2,000 to $5,000.

How Long Does the Approval Process Take?

Once you submit the application to the DHHS, it typically takes 45 to 90 days for the state to review the financial snapshot and issue an approval. If you request a Fair Hearing to increase your allowances, the process can be delayed by an additional 2 to 4 months while you wait for a court date.

Frequently Asked Questions (FAQ)