When a married couple considers paying for long-term care with TennCare/Medicaid, they are split into two categories: Institutionalized Spouse (IS) and Community Spouse (CS). It is essential to understand the differences between the two when Spousal Planning for TennCare/Medicaid. Specifically, the IS is applying for TennCare/Medicaid benefits while the CS is not. Under the same application, Medicaid always determines whether spousal resources are countable or exempt. As you would expect, countable resources can prevent eligibility, but exempt resources do not. Traditionally, retirement accounts, such as IRAs and 401Ks, for the IS are always countable resources for qualification purposes. On the flip side, the CS’s retirement accounts did not count if the CS was taking monthly payments equal to a required minimum distribution (RMD).