When a family has one spouse in the nursing home, the healthy spouse almost always asks, “Are
they going to take all of my husband’s income? I won’t have enough to live on.”
It’s important to understand that Medicaid treats assets differently than they treat income. Regarding
assets, the healthy spouse is allowed to keep half of the available assets, up to $123,600. In PA,
she is also allowed to keep her own retirement account (not true in all states).
Also, in a married case, the healthy spouse is allowed to keep the house. It usually makes sense to
retitle the house solely in the name of the healthy spouse. This requires a Power of Attorney with
strong gifting authority. Unfortunately many documents lack this language.
In most cases, some or all of the sick spouse’s income will be diverted (in other words, given) to the
healthy spouse. It works like this. The state says a healthy spouse should have a minimum monthly
needs allowance of $2,030, plus an additional amount to pay for house taxes and house insurance
and possibly a mortgage. The maximum is $3,090 per month. So if the formula results in the healthy
spouse needing $3,090 per month, and the healthy spouse only has social security of $1,200 per
mouth, the state will allow her to keep the difference from her husband’s security, pension, and other
If you would like to learn more about Nursing Home Medicaid eligibility and some smart planning
options, consider attending one of our upcoming workshops.