When one spouse needs a nursing home: Medicaid's protections for the spouse at home
By Bennett Dixon, founder of MedicaidChecklist · Every figure cited to an official source · Last verified
The fear is understandable and specific: if one spouse enters a nursing home and applies for Medicaid, is the spouse still at home left with nothing? Federal law says no. The “spousal impoverishment” protections set aside assets and income for the spouse who stays in the community — published figures, updated annually, that most families have never heard of when they need them.
The protected share of assets (CSRA)
The community-spouse resource allowance lets the at-home spouse keep a share of the couple's countable assets — generally set when care begins, separate from the applicant's own asset limit. States implement it differently within federal minimum and maximum figures, so the same couple can be treated quite differently across a state line.
The income allowance (MMMNA)
Income follows a parallel rule: if the at-home spouse's own income falls below the state's minimum monthly maintenance needs allowance, part of the applicant's income can be directed to them rather than to the cost of care. And the home itself is exempt while the spouse lives in it.
Published 2026 figures in the states we cover
| State | Protected assets (CSRA) | Income allowance (monthly) |
|---|---|---|
| California | up to $162,660 | $4,066.50 |
| Michigan | $32,532–$162,660 | $2,705–$4,066.50 |
| New York | $74,820–$162,660 | $4,066.50 |
| Ohio | $32,532–$162,660 | $2,705–$4,066.50 |
| Pennsylvania | $32,532–$162,660 | $2,705–$4,066.50 |
| Texas | $32,532–$162,660 | $4,066.50 |
Each state's asset-limit page carries the published rule text and its official source. How the allowance is set for a specific couple — especially where a range applies — is determined by the agency, and can be worth an elder-law attorney's hour when the numbers are large.
Why this matters at application time
Married applications involve their own paperwork — several states use a dedicated asset-assessment form to set the spousal share, filed alongside the application. The state guides list the exact forms: California, Michigan, New York, Ohio, Pennsylvania and Texas. As everywhere in this process, the figures here are published rules, applying them is the agency's job, and applying is free directly through the state.
Sources
- California's published spousal-protection rule ("Protections for the spouse at home (CSRA and MMMNA)") — canhr.org
- Michigan's published spousal-protection rule ("Protections for the spouse at home (CSRA and MMMNA)") — www.medicaid.gov
- Ohio's published spousal-protection rule ("Protections for the spouse at home (CSRA and MMMNA)") — dam.assets.ohio.gov
- Texas's published spousal-protection rule ("Spousal Protected Resource Amount (SPRA) for the at-home spouse") — www.hhs.texas.gov