In a letter sent to state Medicaid directors last Friday, the Centers for Medicare & Medicaid Services (CMS) clarified that the agencies can offer same-sex couples the same financial and asset protections available to heterosexual couples when a partner is in a nursing home.
CMS advised state agencies of their ability to ensure that same-sex partners can remain in shared homes without Medicaid liens being applied. States also have the flexibility to protect same-sex partners under estate recovery and transfer of assets rules, according to the guidance.
While states may place liens on the property of a Medicaid recipient needing nursing home care, if there is a spouse in the home, states must protect that spouse from having a lien attached to their home. For same-sex couples, these protections do not always apply.
The CMS letter says state agencies can extend these protections when the same-sex spouse or domestic partner of the Medicaid enrollee continues to reside in their home. The letter also outlines how states can apply other protections to same-sex spouses or domestic partners, for example, by allowing individuals needing institutional care to transfer ownership of their homes without financial penalties. States have the choice of extending these protections.