This is the first in a series discussing the key terms and principles you will encounter when applying for Texas Medicaid nursing home benefits. We will begin with the SPRA, or Spousal Protected Resource Amount.

The Spousal Protected Resource Amount refers to the value of assets the “community spouse” is allowed to keep while the institutionalized spouse remains eligible for Texas Medicaid nursing home benefits. The “community spouse” refers to the spouse remaining in the home that is not receiving Medicaid benefits.

The starting point to determine the value of the SPRA is one-half of the married couple’s non-exempt assets valued as of the first day of continuous institutionalization. That figure is then either increased to $21,912 or decreased to $109,560 (as of 1/1/09).

It doesn’t end there however. While it may appear that the at-home spouse can only keep a maximum of $109,560 in non-exempt assets while the institutionalized spouse qualifies for Texas Medicaid nursing home benefits, there is another opportunity to increase the SPRA. That opportunity comes in the form of a Fair Hearing.

The Fair Hearing is your chance to protect more of your assets if certain conditions are met. It is important to note that the social worker assigned to your case does not have the authority to increase the SPRA, only the Fair Hearing Officer has the authority if you satisfy your burden of proof.

The SPRA is one of the items you’ll be focusing on if your spouse needs to qualify for Texas  Medicaid nursing home benefits and alternative asset protection strategies are not available. Make sure your Texas Medicaid Attorney is prepared to protect your rights if your spouse needs nursing home benefits.

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