When a married couple applies for Medicaid, the Medicaid agency must analyze the couple’s income and assets as of a particular date to determine eligibility. The date that the agency chooses for this analysis is called the “snapshot” date or the "date of institutionalization" and it can have a major impact on a couple’s financial future.

In order to be eligible for Medicaid benefits a nursing home resident may have no more than $2,000 in "countable" assets (the figure may be somewhat higher in some states). Medicaid law also provides special protections for the spouses of Medicaid applicants to make sure they have the minimum support needed to continue living in the community while their husband or wife is receiving long-term care benefits.

In general, the community spouse may keep one-half of the couple's total "countable" assets up to a maximum of $137,400 (in 2022). This is the community spouse resource allowance (CSRA), the most that a state may allow a community spouse to retain without a hearing or a court order. The least that a state may allow a community spouse to retain is $27,480 (in 2022).

Medicaid agencies must pick a date to use to analyze the applicant’s assets. The date that the agency chooses can affect how much money the applicant must spend before qualifying for benefits and how much a spouse is able to keep. It is called the "snapshot" date because Medicaid is taking a picture of the applicant’s assets as of this date.

The snapshot date is the date of "institutionalization." This is the day that the Medicaid applicant enters either a hospital or a long-term care facility for a combined period of 30 days or more. If the applicant enters a hospital or nursing home, stays for 30 days, goes home, and then reenters a hospital or nursing home, the snapshot date is the date the applicant entered the hospital or nursing home for the first stay.

Not all Medicaid long-term care applicants are in an institution. If the applicant is applying for Medicaid home care through a waiver program, the snapshot date is set when the person has applied and the state agency has determined that they need a nursing home level of care.

On the snapshot date, the Medicaid agency counts up all of an applicant’s and his or her spouse’s non-exempt assets (the home, a vehicle, and irrevocable funeral plans are examples of exempt assets). Then depending on the state’s CSRA, the agency determines how much the community spouse can keep. If any assets above $2,000 remain, then that money must be spent down before the applicant will qualify for benefits.

Example: If a couple has $100,000 in countable assets on the snapshot date and the state allows the spouse to keep half the couple’s assets up to the maximum CSRA, the Medicaid applicant will be eligible for Medicaid once the couple's assets have been reduced to a combined total of $52,000 -- $2,000 for the applicant and $50,000 for the community spouse.

Proper planning can help a couple determine the best time to apply for benefits based on the snapshot date and maximize the assets the couple can keep. Consult with an experienced elder law attorney for advice.