What is a Medicaid attribution date, and why Does it Matter?

There are many Medicaid programs, each with their own rules for qualification. This post describes the rules for Facility Medicaid eligibility in Iowa for the year 2020. Each year, DHS may adjust any dollar amounts listed below, so all figures are only accurate for the 2020 calendar year.

The attribution date is used in determining the split of assets between an applicant and their spouse living at home. So if you are a married couple, this post is especially relevant to you. If you’re single, then feel free to skip this information as it won’t apply to your application.

In a previous post, we explained that DHS will look at the total shared assets’ of a couple as of the applicant’s attribution date and use this total to determine the amount the spouse at home is allowed to keep. If you read that post and found yourself wondering what an attribution date is, here is your answer.

An attribution date is the moment in time that DHS uses to determine a couple’s total shared assets for the sake of the Medicaid application. This is the total that they will look at in order to determine the split of assets between the spouse applying for Medicaid and the spouse at home. It is the only total that DHS will use to determine the couple’s asset split when you apply for Medicaid. Imagine it as a financial snapshot of your assets. Things may have changed drastically as little as one day before or after the attribution date; however, DHS only considers the couple’s assets as of this one moment in time.

Now you understand the relevance of this date, but how is the attribution date determined?

The attribution date is the first day of the month that the applicant entered a hospital or nursing home and stayed for a total of 30 consecutive days or more. The 30 days can be spent in both a hospital and a nursing home, as long as the days are consecutive and the applicant never returns home in those 30 days. This part can be a bit confusing, so we’ll include some examples below to expand upon this concept.

Example 1: Bob and Linda are married. On February 28, 2020, Bob went to the hospital and stayed for 10 days before transfering to a nursing home for additional care. After staying in the nursing home for a month, Bob and Linda decided to apply for Medicaid to help pay for Bob’s care. Their attribution date is February 1, 2020.

Example 2: Bob and Linda are married. On February 28, 2018, Bob transitioned to living in a long-term care home. In March of 2020, after Bob had been living in the nursing home for a few years, Linda became concerned about how she will be able to continue paying for his care and her own expenses. So, Bob and Linda decided to apply for Medicaid for Bob. Their attribution date is February 1, 2018.

Example 3: Bob and Linda are married. On February 28, 2020, Linda went to the hospital and stayed for 5 days. She decided to recover at home. After a couple of days at home, Linda determined she needed additional help with her recovery, and she moved into a skilled nursing facility. She made the move into a skilled facility on March 3, 2020. Linda ended up staying long term in the facility, so Bob and Linda decided it’s time to look at Medicaid as an option. Their attribution date is March 1, 2020.

We hope you now feel you understand the importance of the attribution date and how it affects your Medicaid planning. If you are interested further in how DHS uses the total of a couple’s assets to determine the applicant’s spend down, we have a whole post that discusses this topic. Do you have a different question to ask us? Please submit it here, and we’d be happy to answer.

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These posts are purely informational and not to be construed as legal or Medicaid planning advice. We may describe general best practices or give examples; however, without considering your unique situation, this is not necessarily your best option. Please contact us for your free consultation to receive custom-tailored advice.