Where to start › When the money runs out › Spouse at home
Protecting the spouse who is still at home
One of the most important — and most reassuring — parts of Medicaid law exists for exactly this situation: one spouse needs expensive long-term care, and the other is still living at home. Federal "spousal impoverishment" rules are designed so the healthy spouse isn't left with nothing.
The two protections
- A protected share of savings. The spouse at home (Medicaid calls them the "community spouse") can keep a portion of the couple's combined countable assets — the Community Spouse Resource Allowance, or CSRA — instead of everything being spent down. Federal law sets a maximum that this protected amount can reach, and it is adjusted every year. States apply the formula differently — some let the community spouse keep everything up to the federal maximum, others only half of the couple's assets within set floors and caps.
- A minimum monthly income. If the community spouse's own income is low, they may keep some of the ill spouse's income to reach a minimum monthly living allowance (the MMMNA). This too has state-specific figures.
Source: the federal spousal impoverishment provisions, described at Medicaid.gov. Because the dollar amounts change annually and states divide assets differently, we give you the current, dated numbers on your state's page as we build it out — and until then, point you to the office that has them.
Where the public record stops — and who to ask
Exactly how much can the spouse at home keep, in your state, this year? That answer depends on your state and your situation, and it belongs to the people who decide it — not to us. Here is who has it, and exactly what to ask so you arrive prepared instead of lost.
Who to ask: your state Medicaid office for the current figures; an elder-law attorney to plan around them.
What to ask them:
- What is my state's current maximum CSRA (protected savings for the spouse at home)?
- Is my state a '100%' state or a '50%' state for dividing assets?
- What is the minimum monthly income (MMMNA) the spouse at home can keep?
- How should we handle the home and any income-producing assets?
You now know more than most people who walk into that office. That is the whole point of this page.
Who helps you locally — free, and on your side. You do not have to figure this out alone. Your Area Agency on Aging gives free options counseling; reach any of them through the federal Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov (Administration for Community Living). More on the four people who help — and what each one does — on Who helps me locally.