Support for Spouses of Medicaid Recipients


In two recent cases, courts have dealt with support for the spouses of nursing home patients receiving benefits through Medicaid. In both cases, despite court orders the support actually provided to the spouses was diminished.

Share of Cost Calculated

Gustav Gomprecht resided in a New York nursing home while his wife lived in their home. After he became eligible for Medicaid subsidies, the Human Resources Administration determined that Mrs. Gomprecht was entitled to receive $307 per month from her husband, and that the remainder of his income must be paid to the nursing home.

Mrs. Gomprecht brought an action in Family Court (New York’s divorce and separation court) for support. The Family Court awarded her $3,339 per month in spousal maintenance, noting that it was not bound by Medicaid calculations.

The New York Court of Appeals reversed the Family Court. Noting that Mr. Gomprecht was being cared for at public expense, the Court ruled that the former standard of living of Mrs. Gomprecht was not the important consideration for determining support.

Alimony Order Ignored

Ruby Ussery sued her husband for divorce just before he entered a Kansas nursing home in 1993. She was awarded $495 per month in spousal maintenance, and Mr. Ussery then filed for Medicaid assistance.

Mr. Ussery qualified for Medicaid, but the Department of Social and Rehabilitation Services calculated his share of the nursing home cost without deducting the spousal maintenance. The two rulings, taken together, required him to pay $1,465 per month, though his total income was only $1,060.

Mrs. Ussery asked the Kansas Supreme Court to reduce the Medicaid share of cost by an amount sufficient to secure her spousal maintenance payments. The court declined, noting that the Medicaid rules do not permit consideration of spousal maintenance payments. The court also noted, however, that Mrs. Ussery would have been protected if she had not secured a divorce; the case was remanded to the trial court for a determination of whether Mrs. Ussery’s constitutional right to equal protection of the laws had been abridged by the treatment afforded former spouses.

Arizona law in both instances would probably lead to the same result, though community property principles might help in the Ussery case. Arizona recognizes legal separations (such as in the Gomprecht case) as well as divorces (like the Usserys’).

Securing a spousal maintenance order in an Arizona legal separation would not lower the share of cost. Although it is frequently advised by well-meaning friends, divorce is seldom helpful for resolving Medicaid eligibility issues. Still, there is the possibility of securing a new determination of the share of cost after a “fair hearing,” particularly in cases with widely disparate incomes or assets between the marriage partners.

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