This is a generic Affidavit to accompany a Motion to amend or strike alimony provisions of a divorce decree because of cohabitation by dependent spouse. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Spousal Support Form For Medicaid In Chicago
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Multi-State
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Chicago
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US-00003BG-I
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Income Definition & Exceptions This includes employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Nationally, Holocaust restitution payments are not counted as income.
In essence, a Medicaid Asset Protection Trust serves as a firewall that prevents your hard-earned assets from being depleted due to long-term healthcare costs. By transferring ownership of these assets into the trust, you are essentially ensuring they are not counted when assessing Medicaid eligibility.
The Medicaid recipient in the nursing home can keep non-exempt assets totaling $2,000. The spouse who continues to live in the community can keep non-exempt assets, up to $129,084, as of January 1, 2024. This is called the Community Spouse Resource Allowance (CSRA).
The form used for this process is titled "Medical, Cash and SNAP Redetermination Notice" IL444-1893. The first mailing from HFS is a notice the redetermination date is approaching and the Illinois Medical, Cash and SNAP Redetermination Notice will arrive in approximately two (2) weeks.
The Community Spouse Resource Allowance (CSRA) is $109,560 and the Minimum Monthly Maintenance Needs Allowance (MMMNA) is $2,739.
Monthly Maintenance Needs Allowance (MMNA) The MMNA ensures that the healthy spouse who continues to live in the couple's home maintains a certain amount of monthly income while their partner receives their Medicaid long-term care coverage. (Learn more about the ins and outs of MMNA.)
The non-applicant spouse, however, may be entitled to a Monthly Maintenance Needs Allowance (MMNA) from their applicant spouse to prevent spousal impoverishment. Specific to IL, this Spousal Income Allowance, is called a Community Spouse Maintenance Needs Allowance (CSMNA). In 2025, the CSMNA is $3,948 / month.
The asset limit for a married applicant in most states is $3,000. Medicaid considers all assets of a married couple to be jointly owned. So, for a married couple with both spouses applying for Medicaid Long Term Care, all of their countable assets would be counted against their asset limit for both applicants.
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This is called the Community Spouse Resource Allowance (CSRA). The spouse in the nursing home may transfer assets to the community spouse.For help filling it out or for translation services, contact your DHS Family. Community Resource Center. Under the Medicaid spousal impoverishment provisions, a certain amount of the couple's combined resources is protected for the spouse living in the community. To figure the amount of the Community Spouse Maintenance Needs Allowance (CSMNA), subtract the spouse's gross income from the maintenance needs standard. You can apply online using the Application for Benefits Eligibility (ABE) Portal. Illinois Legal Aid Online provides a guided interview called an Easy Form that will help you fill out the forms. This includes money earned from a job or any child or spousal support you get. DO NOT fill out the rest of this form unless the judge tells you complete it.