A single premium immediate annuity (SPIA) is a contract with an insurance company where the non-nursing home spouse pays a sum of money to an insurance company. Consequently, the insurance company sends a monthly check to the non-nursing home spouse for a certain time period or for the rest of their life. In Maryland, and some states, the purchase of a SPIA is not considered to be a transfer (gift) for purposes of Medicaid eligibility, because it is an income stream. Therefore, it transfers countable assets into a non-countable assets. In order for the annuity purchase not to be considered…
If you are applying for Medicaid, the institutional spouse (spouse in nursing home) and their community spouse (spouse not in nursing home) may protect their assets and lifelong savings, retirement IRA etc. by spending those assets on noncountable assets. These expenditures may include: prepaying funeral expenses, paying off a mortgage, making repairs to a home, purchasing a new automobile, updating home furnishings and equipment, purchasing insurance up to $1,500 buying a new home, if under $500,000, (in some states $750,000) puchasing an annuity In the case of married couples, it is often important that any spend-down steps be taken only…
This information is wrong, the spouse who is not in the nursing home, the community spouse, does not have to be left impoverished, for Medicaid qualification.
Frederick, MD 
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