“My Spouse is a Medicaid Recipient in a Nursing Home. Is My Income Protected?”

Once your spouse has been approved for Medicaid to help pay nursing home costs, he or she will likely owe a portion of his or her income to the nursing home each month; this is referred to as the “patient liability” to the nursing home. The monthly patient liability owed to the nursing home is calculated by reducing the gross income of the Medicaid recipient by the following monthly costs: health and dental insurance premiums, Medicare supplemental insurance policy premiums, spousal allocation (if applicable), as well as a Personal Needs Allowance of $52.00. The Medicaid recipient will be allowed to retain a portion of his or her monthly income in order to cover those expenses. The remaining portion of the Medicaid recipient’s income is known as the patient liability; this is the amount to be paid to the nursing home each month.

The Medicaid recipient’s spouse is allowed to keep all of his or her income; there are no income limits for this spouse. The spousal allocation applies if the Medicaid recipient’s spouse who resides at home, or at an assisted living facility, earns gross income of less than $2,465.00 per month (effective July 1, 2023). In such instances, a portion of the Medicaid recipient spouse’s monthly income may be attributed to the at-home spouse so that he or she receives income of at least $2,465.00. This amount may be increased to a maximum of $3,854.00 (effective January 1, 2024) based on the monthly mortgage or rent expense, utilities, homeowner’s insurance and property taxes. The income of the Medicaid recipient’s spouse is always protected in that it is not used in the nursing home liability calculation.

If your spouse lives in a nursing home and is not eligible for Medicaid because of an excess of financial assets, I advise that you consult with an elder law attorney in your area with experience in asset protection in nursing home cases. If you would like to schedule a consultation with Glenn A. Deig, Certified Elder Law Attorney by the National Elder Law Foundation, to discuss your situation, please call my office at 812–423-1500.