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Protecting the spouse who is still at home
One spouse needs costly long-term care. The other still lives at home. In 1988 Congress wrote rules for this, so the spouse at home is not left with nothing. Here is how the rules work, and what they do not promise.
When these rules apply
These rules do not cover everyone on Medicaid. They cover a married person on Medicaid who lives in a care facility, most often a nursing home. They also cover some people who get Medicaid-paid care at home through a state "waiver" program.[1] The official name is the "spousal impoverishment" rules.
The protection is not a set amount that everyone gets. The state runs a formula on your own numbers.
The two protections
- Some savings are protected. The state adds up what the couple owns together. Part of that is set aside for the spouse at home. This is called the community spouse resource allowance, or CSRA.[1] Federal law sets a lowest and a highest amount, and both change every year. Each state has its own way of splitting up what a couple owns, inside those limits. So the amount protected in one state is not the same as in another.
- Some income is protected. Once the spouse in the nursing home is approved for Medicaid, the state works out how much of that spouse's income must go toward the cost of care. Some money is taken out first: a small personal allowance of at least $30, an amount for the spouse at home, amounts for other family members living at home, and the nursing home spouse's own medical bills. What is left goes toward the cost of care.[1] The amount for the spouse at home depends on how much income that spouse already has. It also depends on the money really being handed over to them.
What the spouse at home can keep in 2026
When one spouse goes into a nursing home on Medicaid, the spouse still living at home is allowed to keep some of the couple's savings and income. The federal government sets the lowest and highest amounts. Each state then picks its own number inside that range. So the numbers below are the limits, not your answer.[2]
Savings the spouse at home can keep (the "community spouse resource allowance")
- At least $32,532
- At most $162,660
- These took effect January 1, 2026.
Monthly income for the spouse at home (the "monthly maintenance needs allowance")
- At least $2,705 a month in the 48 mainland states, effective July 1, 2026
- At least $3,381.25 in Alaska and $3,111.25 in Hawaii, effective July 1, 2026
- At most $4,066.50 a month, effective January 1, 2026
If the spouse at home has less income than their state's amount, some of the nursing home spouse's income can be moved over to make up the difference. The part of this amount that covers housing costs is also updated every July 1.[2]
These numbers change every year. Check the date at the top of the sources below. If it's been a while, look up the newest numbers.
A warning about older guides
Some older guides have out-of-date numbers, and that includes an earlier version of this page. Even the main federal Medicaid page still shows example amounts from years ago. You may also see states sorted into "100% states" and "50% states." That is too simple to plan around. Instead, call your state Medicaid office and ask three things:
- What is the amount right now?
- How do you figure it?
- What date did it start?
What only your state can tell you
How much can the spouse at home keep, in your state, this year, with your numbers? Only the state can work that out.
Who to ask: Your state Medicaid office has the current numbers and does the math. An elder-law attorney can help you plan around them.
What to ask them:
- What are our state's lowest and highest amounts of savings the spouse at home can keep (the CSRA) right now? What date did they start?
- How does the state split up what a couple owns? How would that work with what we own?
- What monthly income amount (the MMMNA) applies to us? Can housing costs raise it?
- Can the amount be raised through an appeal (called a "fair hearing") or a court order? For what reasons?
- How do you treat the house, and things we own that bring in income?
Free local help. Your Area Agency on Aging will talk through your choices with you for free. Find yours through the federal Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov (run by the Administration for Community Living).[3] To learn about the four kinds of local helpers and what each one does, see Who helps me locally.
Sources and what they support
Sources checked 2026-09-19 using AI-assisted editorial research. This is a source check, not legal or financial advice.
- CMS, spousal impoverishment. Supports that Congress enacted the provisions in 1988, that they apply to institutionalized beneficiaries and to certain people receiving home and community-based waiver services, that a calculated amount of combined resources is protected for the community spouse, and the post-eligibility deductions including the $30 minimum personal needs allowance, the community spouse income allowance, family allowances and medical expenses. CMS also states the income allowance depends on the community spouse's own income and on income actually being made available. Parts of this page still display example dollar amounts from earlier years, so current figures must come from the annual bulletin below rather than from the overview text.
- CMS informational bulletin, updated 2026 SSI and spousal impoverishment standards (27 April 2026). Supports the CSRA minimum of $32,532 and maximum of $162,660 and the $4,066.50 maximum monthly maintenance needs allowance, all effective 1 January 2026; the $2,705 MMMNA for the 48 states; the Alaska $3,381.25 and Hawaii $3,111.25 figures effective 1 July 2026; and the annual 1 July adjustment of the housing allowance. These are federal minimum and maximum standards. States apply their own procedures within them, hearings can change what is protected in an individual case, and every figure is superseded when CMS issues the next bulletin.
- Administration for Community Living, Eldercare Locator. Supports the referral route to a local Area Agency on Aging for free options counseling. An Area Agency on Aging does not determine Medicaid eligibility.
Removed in this pass: the "100% state / 50% state" shorthand for dividing assets, which is too coarse to plan with, and an undated reference to Medicaid.gov in place of the dated annual standards.