The Supreme Judicial Court of Massachusetts holds that a Medicaid applicant must establish a complete marital breakdown to be exempt from reporting spousal income and assets. In Freiner v. Secretary of the Executive Office of Health and Human Services (Mass. No. SJC-13514, June 14, 2024).
Costa and Mary Tingos lived together since they married in 1957 until Mr. Tingos moved into a nursing home in May 2015. During the marriage, Mr. Tingos had a gambling problem, which strained the relationship. After considering divorce but deciding to remain together for their religion and children, they maintained separate finances, though they filed joint tax returns and shared expenses.
The relevant statute, 130 Code Mass. Regs. § 517.011, permits a spouse to qualify for Medicaid without full disclosure of marital resources in two instances. One is when the spouse refuses to cooperate. The second is when the spouse cannot be found. Reading these two together suggests that the marriage must have completely broken down. Allowing eligibility for nondisclosing couples absent a total marital breakdown would drain the Commonwealth’s limited resources and potentially create a loophole for wealthy couples to qualify.
The record shows a certain degree of spousal cooperation, as they lived together for over 50 years, contributed to household expenses, and filed taxes jointly. Additionally, Mrs. Tingos cooperated with her husband by being his financial agent. For these reasons, the denial of benefits was reasonable, not arbitrary and capricious.
Supreme Judicial Court of Massachusetts affirms the Superior Court Judge’s decision. Mr. Tingos failed to show a complete marital breakdown that would cause his wife to refuse to participate in his application.