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Medicaid Recipient Issues When the Community Spouse Dies First: Protections, Rules, and Key Planning Strategies

Recording of a 90-minute CLE video webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Thursday, October 6, 2022

Recorded event now available

or call 1-800-926-7926

This CLE webinar will guide elder law attorneys on the challenges Medicaid recipients face upon the passing of the community spouse. The panel will discuss community spouse protections and applicable rules, counting of assets, and available planning techniques to maintain Medicaid eligibility as a preventative measure upon the community spouse's death.


Elder clients rarely plan for Medicaid asset preservation, not anticipating the illness or injury that requires immediate nursing home placement and an imminent need for Medicaid eligibility. But, what happens when the community spouse passes away before their Medicaid recipient spouse? Elder law attorneys must be equipped to handle these circumstances and implement effective planning techniques to maintain Medicaid eligibility.

Typically, counsel can protect the Medicaid recipient by using qualified annuities and making countable assets unavailable through DRA-qualified promissory notes. In addition, special protections are provided to spouses of Medicaid applicants to ensure the spouses have the minimum support as needed, along with the ability to leverage the Community Spouse Resource Allowance. However, this process can be substantially derailed if the community spouse dies first.

The panel will outline best practices for meeting the stringent requirements for Medicaid eligibility and maintaining eligibility in the event of the passing of the community spouse.

Listen as our distinguished panel of attorneys experienced in Medicaid asset preservation reviews the eligibility requirements and available planning techniques to maintain Medicaid eligibility as a preventative measure and upon the death of the community spouse.



  1. Overview of community spouse protections
  2. Community spouse resource allowance
  3. Preemptive measures and revising the estate plan
  4. Maintaining Medicaid eligibility in case the community spouse dies first


The panel will discuss these and other key issues:

  • Best practices to convert a client's Medicaid-countable assets to exempt assets

  • Use of the Community Spouse Resource Allowance, Medicaid qualified annuities, and DRA qualified promissory notes for the client and spouses' benefit

  • Protections available to the community spouse under Medicaid

  • Tools available to maintain Medicaid eligibility for a recipient upon their community spouse's death


Gusmano, Kelly
Kelly R. Gusmano

Woods Oviatt Gilman

Ms. Gusmano is an Associate at the firm in the Family Wealth and Estate Planning Department. She concentrates her...  |  Read More

Krause, Dale
Dale M. Krause, J.D., LL.M.

President and CEO
Krause Financial Services

Mr. Krause, J.D., LL.M. is the President and CEO of Krause Financial Services – a Wisconsin-based firm that...  |  Read More

Negrin-Wiener, Melissa
Melissa Negrin-Wiener

Senior Partner
Cona Elder Law

Ms. Negrin-Wiener manages the Government Benefits Department, concentrating her practice in the areas of asset...  |  Read More

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