Updated August 3, 2026. Quick answer: if the at-home spouse’s own income is below a federally set monthly floor, income can be shifted from the spouse in care to them to make up the difference. The at-home spouse does not have to hand over their own income, and in many cases they receive some of their partner’s.
How the allowance is calculated
the ‘community spouse monthly income allowance’ for a community spouse is an amount by which—(A) except as provided in subsection (e), the minimum monthly maintenance needs allowance … for the spouse, exceeds (B) the amount of monthly income otherwise available to the community spouse … the applicable percent … of 1/12 of the income official poverty line … plus an excess shelter allowance … The minimum monthly maintenance needs allowance established under subparagraph (A) may not exceed $1,500 (subject to adjustment under subsections (e)…
— 42 U.S.C. 1396r-5(d)(2); (d)(3)(A)-(C); (g) (indexing)
Two moving parts. The floor is an applicable percentage of one twelfth of the federal poverty line, plus an excess shelter allowance where housing costs exceed a threshold — so a spouse with high rent or a mortgage can be entitled to more. And the whole thing is subject to a cap.
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.
The rule people get wrong: whose name is on the payment
(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 names of the institutionalized spouse or the community spouse, or both, and to another person or persons, the income shall be considered available to each…
— 42 U.S.C. 1396r-5(b)(2)(A)(i)-(iii); (b)(2)(B)(ii)
This is worth stating plainly because it is the source of most of the fear. Income paid solely in the at-home spouse’s name is theirs. It is not pooled, it is not surrendered, and it does not count against the applicant. Income in both names is split in half. Income from a trust follows the trust’s own terms.
So a couple where the pension is in the name of the spouse entering care, and the at-home spouse has little income of their own, is often the case where the income allowance matters most — and it runs in the direction people do not expect.
The shelter allowance is worth checking properly
Because it is the part that varies most between households and the part most often under-claimed. Rent or mortgage, property taxes, insurance and a utility allowance can all feed into it. If the at-home spouse’s housing costs are high, the allowance can be materially larger than the base figure suggests.
If it is still not enough
A fair hearing can increase the resource allowance where the income it generates is inadequate to reach the monthly needs allowance. Ask about it explicitly — it is not applied automatically.
Related: the overview · the resource allowance.
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.