Married Couples and Long-Term Care Medicaid
When one spouse needs nursing home care or other long-term care and the other spouse stays at home, Long-Term Care Medicaid has special rules so the spouse at home is not left without money to live on. These are called the spousal impoverishment rules. This section explains them in plain language.
Figures change periodically. Double-check current amounts before relying on them.
The short version
- When one spouse applies, the state counts the assets of both spouses, no matter whose name they are in.
- The spouse at home (the “community spouse”) can keep a share of the couple’s assets, called the Community Spouse Resource Allowance (CSRA). In 2026 the federal range is $32,532 to $162,660.
- The spouse at home can also keep income, called the Minimum Monthly Maintenance Needs Allowance (MMMNA). From July 1, 2026, the federal minimum is $2,705 a month (higher in Alaska and Hawaii), and the maximum is $4,066.50 a month.
- The spouse at home’s own income is not counted toward the applicant’s eligibility.
- When both spouses need care, different rules apply.
Guides in this section
| Guide | What it covers |
|---|---|
| Spousal impoverishment rules | The big picture: who is protected, how assets and income are treated, and when the rules apply |
| Community Spouse Resource Allowance (CSRA) | How much of the couple’s assets the spouse at home can keep, with examples |
| Minimum Monthly Maintenance Needs Allowance (MMMNA) | How much income the spouse at home can keep, including the housing (shelter) adjustment |
| When both spouses need care | How the rules change when both spouses need nursing home or home care |
2026 federal spousal figures
| Item | 2026 figure |
|---|---|
| CSRA: minimum | $32,532 |
| CSRA: maximum | $162,660 |
| MMMNA: minimum (July 1, 2026 to June 30, 2027) | $2,705 a month ($3,381.25 in Alaska, $3,111.25 in Hawaii) |
| MMMNA: minimum (until June 30, 2026) | $2,643.75 a month |
| MMMNA: maximum (all of 2026) | $4,066.50 a month |
| Housing (shelter) standard from July 1, 2026 | $811.50 a month |
| Asset limit for the applicant spouse (most states) | $2,000 |
Source: CMS, 2026 SSI and Spousal Impoverishment Standards (Medicaid.gov). Some states use different amounts within these federal limits. Each state guide shows that state’s figures.
Where to go next
Because so much depends on getting the spousal rules right, married couples are encouraged to work with a Certified Medicaid Planner (CMP) before applying.
Transfers between spouses are allowed, but gifts to anyone else can still cause a penalty. See Look-Back and Gifts. For the steps of applying, see How to apply for Long-Term Care Medicaid.
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.