How Much Can I Keep if My Spouse is On Medicaid?

Nursing home residents receiving Medicaid must meet very strict asset and income limits.  Assets for a nursing home resident on Medicaid may not exceed $2000. But the “well-spouse” or community spouse is not limited to the same degree.  First off, Florida does not limit a community spouse’s income.  The community spouse is not legally obligated in Florida to pay the nursing home bills of their spouse.  Remember that each state is free to create their own qualification rules (with certain limitations) so if you are contemplating nursing home Medicaid in a different state, you need advice by an Elder Law attorney in that state.

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Florida has a minimum standard for the amount of monthly income a community spouse needs to avoid being impoverished.  This figure is called the Minimum Monthly Maintenance Needs Allowance or MMMNA.  If the spouse’s income falls short of the MMMNA, Medicaid allows a portion of the nursing home resident’s income that would otherwise go to the nursing home, to be diverted to the community spouse.  The amount that may be diverted is the amount needed to elevate the community spouse’s income level to the MMMNA.  Effective July 1, 2023, the MMMNA has increased to $2465 (up from $2288.75).  The MMMNA is based on the federal poverty guidelines and adjusts each year for inflation.

There are certain special circumstances-for example, high housing or utility expenses-when income may be diverted to bring the community spouse’s income as high as $3715.50 (up from last year’s number of $3435).

Also in 2023 the community spouse may have up to $148,620 in assets in his or her name without being “over asset.”  And remember that the home is still exempt under Florida’s homestead protection regardless of value when the community spouse still resides there.  (For a single nursing home Medicaid recipient, the homestead is still protected and excluded up to the home equity cap of $688,000.)

So, to recap, a community spouse whose spouse is on Medicaid in a nursing home may still have the following resources:

•                     Income in any amount (plus possible diversion of a portion of the nursing home resident’s income)
•                     A homestead of any value
•                     Up to $148,620 of general or non-excluded assets such as investments and bank accounts

There are many more rules for Medicaid eligibility in Florida that apply to the applicant and spouse, and the rules are always subject to change.  The advice and guidance of an experienced Elder Law attorney can make the difference between qualifying for Medicaid or having to private-pay for a nursing home stay at rates exceeding $10,000 per month.  

If it looks like your loved one does not qualify for benefits, do not give up!  There are many legal strategies that may allow your loved one to access benefits and to preserve a good portion of assets before you “spend down” and lose everything.  Steps can often be taken even if your loved one is already in a nursing home.  We call that “crisis” Medicaid planning.  We at Burzynski Elder Law have experience in working with clients either for “crisis” or “pre-crisis” Medicaid planning.  To schedule a consultation with us, call us today at 239-434-8557.