Medicaid and Community Spouse Assets

Most know that to qualify for medicaid, the nursing home resident can't have more than $2,000 in countable assets. But, what if the medicaid recipient has a spouse at home. How many assets can that community spouse keep?

-- By K. Gabriel Heiser, Attorney

Most people know that in order to qualify for Medicaid coverage of a long-term stay in a nursing home, the nursing home resident cannot own more than $2,000 in cash or other "countable" assets. But if you're married, and one spouse is going into a nursing home and the other is remaining "in the community" (i.e., continuing to reside at home), how much can the so-called "Community Spouse" retain? That amount is determined by a combination of both federal and state Medicaid laws. (Note that for these purposes it doesn't matter whether assets are titled in the sole name of the nursing home spouse, the Community Spouse, or jointly in both names.)

The basic rule is that the Community Spouse can retain 50% of all of the countable assets of both spouses, based on what they own when the other spouse first enters the nursing home for a continuous period of at least 30 days.

Most of the states only permit the at-home spouse to protect one-half of the total amount of the couple's assets, up to $109,560, but with a minimum of $21,912. So if the couple's total assets are under $21,912, the Community Spouse can retain it all; if their total assets are between $21,912 and twice that amount (i.e., $43,824), the Community Spouse retains $21,912; if between $43,824 and $219,120, the Community Spouse retains half; and if over $219,120, the Community Spouse is limited to protecting $109,560.

Here are some additional examples:


  1. Assume a couple has total assets of $30,000. Half of that is $15,000, which is less than the "floor" amount, so the at-home spouse can protect $21,912; the balance must be "spent down" before the nursing home spouse can qualify for Medicaid.
  2. If the couple's assets total $100,000, then the Community Spouse can protect the full 50% amount: $50,000.
  3. If the couple's assets total $300,000, the Community Spouse's protected amount is limited to $109,560.

States following the above rule are known as "50% states." However, the most lenient states ("100% states") permit the at-home spouse to retain 100% of the couple's combined assets, but never more than $109,560. So if the couple's total assets are, say $150,000, the Community Spouse can protect not just 50% ($75,000) but $109,560. (The $109,560 figure changes annually, to keep up with inflation; this is the 2009 amount.)

In all states, once the Community Spouse's share is set aside, the nursing home spouse can keep up to $2,000 in cash, but the balance of the couple's assets must be eliminated somehow before the nursing home spouse can qualify for Medicaid.

So what do you do with the "excess" assets over the limits discussed above? The state Medicaid administration department will tell you that you must "spend down" the excess assets, and if it's a small amount, that's certainly the simplest way to qualify.

Another alternative is for the couple to simply give away the excess, but that will cause a period of disqualification from Medicaid eligibility for the nursing home spouse.

The couple could convert some or all of the excess from "countable" to "non-countable," e.g., buying a new car, improving the house, purchasing a Medicaid annuity, etc.

Finally, many of these options are quite technical and require the skills and advice of an experienced elder law attorney. Unless you're an attorney "in the trenches" on a daily basis, it's easy to miss a recent state Regulation or Agency Letter and make a mistake that will wind up costing you $1,000s!

K. Gabriel Heiser is an attorney with over 25 years experience in elder law and estate planning. Heiser is the author of “How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets,” an annually updated practical guide for the layperson. For more information about this book, visit Medicaid Secrets.

New! Comments

Leave a comment about this article in the box below and share it with your Facebook friends.

Have a Medicaid Question or Comment?

We'd love to hear your questions, comments or opinions. Submit them here and other visitors can read them and comment on them. An e-mail address is not required.

The purpose of this feature is to stimulate discussion and share experiences regarding topics of interest. However, please note these submissions are not reviewed for legal accuracy. They may not apply to your situation and should not be considered legal advice. For specific legal advice you must consult with your attorney.

What Other Visitors Have Said

Click below to see contributions from other visitors to this page...

Any Limitations on Gaming Medicaid System?  Not rated yet
Medicaid System Favors Married Heterosexuals over Singles and Gays I despise our gummint's socialist programs, including medicaid, particularly …

Click here to write your own.

Medicaid Planning: Life Estate in House | Does the $13,000 Gift Tax Exemption apply to Medicaid? | Planning For Medicaid Coverage | Effect of Life Insurance Proceeds On Medicaid Eligibility | New Medicaid Annuity Rule Explained | How Can an Irrevocable Trust Be Used in Medicaid Planning? | Selling the House and Medicaid Qualification | How To Qualify For Medicaid If My House Is Worth More Than $500,000 | What is Elder Law? | Living Trust and Medicaid | What Is An Inheritor's Trust? | Should I Take Out a Loan Against My House to Pay For A Nursing Home? | Can I Give My House to My Child and Qualify for Medicaid? | Elder Care Lawyer Fees | Choosing A Nursing Home | Do I Need a Will? | Capacity To Sign a Will, Trust or Power of Attorney | Second Marriage Will Issues | Special Needs Trust Issues | What is a Common Law Marriage? | What is a Medicaid Annuity? | How does a Medicaid Annuity Work? | How To Protect My Home and Still Qualify for Medicaid | Medicaid and Spousal Will Election | Do It Yourself Medicaid Planning | Medicaid Rules and Reverse Mortgages | How Does Life Insurance Policy Ownership Affect Medicaid Eligibility? | Medicaid Estate Recovery Rules | Medicaid Estate Recovery Planning | Limitations on Medicaid Estate Recovery | Do Medicaid Plans Work? | Nursing Home Costs and Payment Options | Don't Be Too Cheap! | What Happens to My Home If I Go On Medicaid? | Can Spouse Receiving Medicaid Pay Income to Community Spouse? | Will Medicaid Exempt My Home If I Leave It? | Tips for Discussing Wills and Powers of Attorney With Your Parents | Elderly Marriage Issues | Durable Power of Attorney Medicaid Considerations |

From Medicaid and Community Spouse Assets to Medicaid Questions | Estate Planning Blog | Basics of Estate Planning | Selecting a Financial Planner | Estate Planning and Taxes | Is This Good Time to Buy a House? | Incorporate My Business | Best Low Cost Investment | Fringe Benefit Plans | Estate Planning and Charitable Giving | Health Insurance Comparisons | Best Medicare Supplement Plan | Retirement and Estate Planning | What is a Power of Attorney? | Current Estate Planning News | Estate Planning Forum | Estate Planning Books | Choosing an Estate Planning Attorney | Find a Probate Attorney | Estate Planning Questions |

Return to Home Page

About Us | Contact Us | Site Search | Terms of Use / Privacy Policy

Subscribe to
Estate Planning Hub

Your First Name

Your E-mail Address

We keep this private.

Follow the Estate Planning Blog.

--by Beth Heikkinen
Marquette, Michigan
I just want to thank you for this site. It answered my questions. I think many people that do research on the net take it for granted and when they find what they are looking for they forget "someone put time, money, etc into providing me with this information."

Thank you!

Like This Site

Visit Our Social Media Pages

Become a Fan of Estate Planning Hub on Facebook Follow EstatePlanningHub on Twitter Follow EstatePlanningHub on Google+ Subscribe EstatePlanningHub Video on YouTube

Get a PDF version of this website and its sister site here.