Resources are determined by adding the total resources that are individually and jointly available to the couple as of the month of the individual’s entry into the nursing facility, regardless of the date of application for Medicaid. For ADvantage and HCBW use the date of application to determine total resources for the couple. The amount determined as the spousal share is used for all subsequent applications for SoonerCare, regardless of changes in the couple’s resources. The protected spousal share cannot be changed for any reason. When application for SoonerCare is made at the same time the individual enters the NF, OKDHS Form 08MA012E, Title XIX Worksheet, is used in lieu of OKDHS Form 08MA011E.

The Community Spouse (CS) may protect up to the Maximum resource standard as shown on Appendix C-1, Schedule XI and the Institutionalized Spouse (IS) may reserve up to the Maximum resource standard as shown on Appendix C-1, Schedule VIIID.1.

Example 1: If one half exceeds the Maximum resource standard as shown on Schedule XI, any excess will need to be spent down to bring the (CS) down to the Maximum resource standard.

Mr. & Mrs. Smith have a total of $500,000 in resources. The resources are split in half, which equals $250,000. As ½ exceeds the Maximum Standard of $157,920, up to $157,920 is protected for the CS. As the IS can only have $2,000 in resources, the couple will have to spenddown to (CS $157,920) + (IS $2000) = $159,920. As long as IS is in ICF care over 30 days it is protected even if the IS returns home. The standard that was used at the time of the division of assets remains the same as well.

Example 2: If one half of the total resources are less than the Minimum resource standard on Schedule XI, the IS may deem a portion of his/her resources to bring the CS’s resources up to the Minimum resources standard.

Mr. and Mrs. Rawlins have a total of $48,000 in resources. The resources are split in half, which equals $24,000. As the Minimum resource standard is $31,584 the IS may deem $7,584 over to the CS to bring the amount up to the standard of $31,584. As the IS can only have $2000 in resources, the couple will have to spenddown to (CS $31,584) + (IS $2000) = $33,584.

Example 3: If the total resources are less than the Minimum resource standard, the CS may retain the total amount.

Mr. and Mrs. Shirley have a total of $20,000 in resources. The resources are split in half, which equals $10,000. As this amount is less than the Minimum resource standard, the total amount of $20,000 can be protected for the CS. This leaves (CS $20,000) + (IS $0). No spenddown is necessary.