May the community spouse retain any income from their spouse who is in a nursing home and on Medicaid?

Co-authored by Joanna C. Feldman

Generally speaking, Medicaid rules require most of one’s monthly income be contributed toward the cost of one’s care in a nursing home. When the spouse of the Medicaid recipient remains at home, however, the impact of losing the other spouse’s additional income can be detrimental. The spouse at home (known as the community spouse), for example, may not receive substantial social security retirement benefits or a pension. To help deter what became known as “spousal impoverishment,” the law evolved to permit the community spouse to retain all or some of the Medicaid recipient’s income if the community spouse’s income falls below a certain amount.

In 2018, if the community spouse’s income falls below $3,090.00 per month, the community spouse is allowed to keep so much of their spouse’s income to raise the community spouse’s income to that level, which is known as the minimum monthly maintenance needs allowance, or MMMNA. If, for example, the community spouse’s income is $1,000.00, and their spouse’s income is $2,000.00, the community spouse would be permitted to keep all of their spouse’s income. But if the community spouse’s income is $1,000.00, and their spouse’s income is $3,000.00, the community spouse would be permitted to keep $2,090.00 of their spouse’s income. The rest would go toward the spouse’s care in the nursing home.