Health Insurance & Medical Costs · Surprise rank #27
Spouse Needs Nursing-Home Medicaid? Keep Far More of the Family’s Money Than You Think!
Medicaid's spousal-impoverishment rules can protect substantial income and assets for the spouse who remains in the community when the other spouse needs qualifying long-term care.
Who
Married couples when one spouse is institutionalized, receiving qualifying home- and community-based waiver services or enrolled in qualifying managed long-term care and the other spouse remains in the community.
What to do
Start here: Request a spousal-impoverishment resource assessment from the local department of social services; NYC residents can use the HRA Medicaid route.
Eligibility: The couple must meet the Medicaid spousal-impoverishment rules. The protected resource amount depends on the couple's countable resources and the applicable spousal share.
What you get
Special Medicaid budgeting rules protect a Community Spouse Resource Allowance and a monthly maintenance-needs allowance instead of requiring the couple to spend down everything.
Benefit: For 2026, the community spouse can generally keep at least the New York minimum resource allowance and potentially a spousal share up to the federal maximum, plus a monthly income allowance.
Possible value: For 2026, the federal maximum Community Spouse Resource Allowance is $162,660 and the maximum monthly maintenance-needs allowance is $4,066.50; individual results vary.
Good to know
Important: The $162,660 figure is a maximum, not an automatic amount every spouse may keep. A higher amount can sometimes be established by fair hearing or court order under specific rules.
Availability: Active; 2026 amounts
Why people miss it: Families often believe nursing-home Medicaid requires spending nearly all marital assets before learning about the separate community-spouse protections.
Sources reviewed: Aug 10, 2026