The Elrod Firm


How Does Medicaid Treat Income For Married Couples?

Justin, my husband has dementia and his doctors say he will have to move to a nursing home soon. We will try to apply for Medicaid because the facility I prefer costs around $6,000 per month, but I’ve heard that all of our household income must go toward the nursing home bill before Medicaid pays the rest. This is going to leave me broke! Is this right?   – Sharon

Sharon, Medicaid has different income rules depending on whether the Medicaid applicant is single or married. What you heard about contributing virtually all income to the cost of care is generally correct for a single applicant. But if the Medicaid applicant is married and his spouse is living at home, as in your case, some significant income protection rules apply.

As a general rule, the spouse residing in the nursing home must pay all of his income to the facility (after paying health insurance premiums and setting aside $40 as a personal needs allowance). But the income of the spouse at home is completely protected; she is permitted o keep it for herself to meet her own monthly expenses. Medicaid rules go one step further to protect even a portion of the nursing home spouse’s income when the spouse at home does not receive at least $1,967 on her own. In addition to keeping all of her own income, she can keep a portion of the income that otherwise would have been due to the facility to ensure she receives no less than $1,967 for her own monthly expenses.


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