Updated August 3, 2026. Quick answer: the spouse who stays at home does not have to become destitute for the other to qualify for Medicaid. Federal law since 1988 protects a share of the couple’s savings, a monthly income floor, and normally the house and a car. The rules are real, they are federal, and they are the opposite of what most people are told at the point of crisis.
What the community spouse keeps
| What | The protection |
|---|---|
| A share of the savings | The community spouse resource allowance — broadly half the couple’s countable resources, between a floor and a ceiling |
| A monthly income floor | The minimum monthly maintenance needs allowance — if the at-home spouse’s own income is below it, income can be shifted from the institutionalised spouse to make it up |
| Their own income | Income paid in the community spouse’s name alone is theirs. There is no requirement to hand it over |
| The house | Normally not a countable resource while a spouse lives there — though estate recovery is a separate question that arrives later |
The single most important mechanical fact
The couple’s resources are counted once, at a fixed moment, and that moment is usually already in the past by the time anyone reads a page like this:
There shall be computed (as of the beginning of the first continuous period of institutionalization (beginning on or after September 30, 1989) … (i) the total value of the resources to the extent either the institutionalized spouse or the community spouse has an ownership interest, and (ii) a spousal share which is equal to ½ of such total value.
— 42 U.S.C. 1396r-5(c)(1)(A)
That is the snapshot date, and it is the beginning of the first continuous period of institutionalisation — not the date of the Medicaid application, and not today. Spending down after the snapshot does not reduce the figure the assessment was based on.
Income is attributed by whose name is on it
(i) if payment of income is made solely in the name of the institutionalized spouse or the community spouse, the income shall be considered available only to that respective spouse; (ii) if payment of income is made in the names of the institutionalized spouse and the community spouse, one-half of the income shall be considered available to each of them; (iii) if payment of income is made in the…
— 42 U.S.C. 1396r-5(b)(2)(A)(i)-(iii); (b)(2)(B)(ii)
Solely in one name, it is that spouse’s. In both names, half each. This is the rule that decides whether a pension or an annuity payment counts against the person applying, and it turns on the payee, not on the marriage. How the income allowance works.
What this page will not do
We are not printing this year’s figures. The amounts in the statute are 1988 base amounts, and the law requires them to be increased every year by the change in the consumer price index. The current published figures are much higher. CMS publishes them annually and CMS blocked every request from us this session, so rather than print a number that would send someone to the wrong conclusion, we publish the mechanism and tell you to get the current figure from your state Medicaid agency.
It also will not tell you that any particular strategy works in your state. Medicaid long-term care is state-administered within federal rules, and states differ on the resource allowance, on how income is treated, and on whether some arrangements are recognised at all. This is a subject where a qualified elder-law attorney in your own state earns their fee, and where decisions are hard to reverse.
What we can tell you is that the protections exist, that they are federal, and that the belief that a couple must spend everything before either qualifies is wrong. That belief costs families a great deal, and it is why this page starts where it does.
Related: the resource allowance · the snapshot date · Medicaid-compliant annuities · the penalty period.
General information drawn from federal statute and regulation, not legal advice. Medicaid long-term-care eligibility is administered by each STATE within federal rules, and states differ materially – on the resource allowance, on how income is counted, and on whether some strategies are recognised at all. Federal figures are adjusted annually; every figure here is labelled with what it is and when it applied. Decisions in this area are hard to reverse and often need a qualified elder-law attorney in your own state. We sell nothing on these pages and we do not refer you anywhere for a fee.