Spouses Do Not Need to Be Estranged to Request Spousal Waiver From Medicaid Application Process

A New Jersey appeals court rules that a married Medicaid applicant could request a spousal waiver for undue hardship even though the spouses were not estranged because the applicant's spouse refused to provide financial information. N.S. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-3562-17T2, July 8, 2019).

N.S. lived with his wife, D.S., before he entered a nursing home. N.S.'s daughter, L.P., applied for Medicaid on his behalf. L.P. submitted information on N.S.'s finances to the state, but she stated that she was unable to obtain information from D.S. The state sent information requests directly to D.S., but she did not respond. N.S. asked that the state process N.S.'s application without regard for D.S.'s income because D.S.'s refusal to cooperate created an undue hardship. The state denied N.S.'s request for a spousal waiver and denied the Medicaid application.

L.P. appealed, arguing that she was unable to get information from D.S. because D.S. became stressed and asked her to stop pressuring her for information. The state found there was no evidence of a break in marital ties, so it denied the request for a spousal waiver. L.P. appealed to court.

The New Jersey Superior Court, Appellate Division, reverses and remands, holding that there is no requirement in federal law that "spouses be estranged in order to receive a spousal waiver for an undue hardship." The court holds that the "determination of undue hardship should be a fact-sensitive inquiry taking into account the totality of the circumstances," and it remands to the state to process N.S.'s application based on the information and documents already submitted.

For the full text of this decision, go to: https://njcourts.gov/attorneys/assets/opinions/appellate/unpublished/a3562-17.pdf?c=pGD

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