Asset Protection If a Spouse Goes into a Nursing Home

Many people plan carefully for their financial needs in retirement, but often overlook how a disability could impact their situation. Unfortunately, disability is one of the leading reasons individuals require nursing home care. Understanding Medicaid laws and exploring asset protection strategies can help you learn how to protect assets if a spouse goes into a nursing home or needs long-term care. Since asset protection can be complex, consulting a financial advisor can provide valuable guidance tailored to your specific situation.

What Happens to Your Assets When Your Spouse Goes into a Nursing Home?

If your spouse moves into a nursing home, they may qualify for Medicaid to cover their care. Eligibility is determined by your state and is based on your spouse’s assets, with Medicaid generally treating assets owned by either spouse as joint resources for this calculation, even if they are titled in only one name. As the spouse remaining at home, often called the community spouse, you are typically allowed to retain up to half of the couple’s assets. This provision, known as the Community Spouse Resource Allowance (CSRA), allows you to keep up to $162,660 from shared assets in 2026 ¹ .

In most cases, the community spouse is not required to contribute to nursing home costs, even if they are still working, unless their income exceeds a certain threshold. On the other hand, if the community spouse has a low income, they may be eligible to receive a portion of the institutionalized spouse’s income. Additionally, there are various strategies beyond the standard legal protections to help safeguard assets in these situations.

What Is the Minimum Monthly Maintenance Needs Allowance (MMMNA)?

The calculation determining how much money a community spouse keeps is called the minimum monthly maintenance needs allowance (MMMNA). Medicaid’s spousal protection laws stipulate a minimum of $2,643.75 per month in 48 states, including the District of Columbia. That minimum is $3,040 in Hawaii and $3,303.75 in Alaska due to the higher cost of living in both states. The maximum amount is $4,066.50 per month. Once calculated, the government does not count this as income when deciding if the institutionalized spouse qualifies for Medicaid.

Additionally, suppose you or your spouse are trying to get on Medicaid and have given assets to your family members in the last five years. Gifts could make the spouse in the nursing home ineligible for a certain period. The government would extend the ineligibility according to the value of the assets and the state’s average rate for nursing home care. These are things that can be avoided and planned for in advance to maximize the dollars both you and your spouse can have available in this situation.

How to Protect Assets If Your Spouse Goes into a Nursing Home 

If your spouse goes into a nursing home, it doesn’t mean you have to sink your hard-earned savings and retirement accounts to pay for expenses for your institutionalized spouse. Instead, there are four ways you can continue to benefit from your nest egg while still having Medicaid pay for nursing home expenses.

1. Buy a Medicaid-Compliant Annuity

A Medicaid-compliant annuity can help the institutionalized spouse qualify for Medicaid. Usually paying for an annuity can deplete a couple’s resources, which could actually help a couple in this situation. The benefit is that the institutionalized spouse has fewer reportable assets and will more likely be eligible for Medicaid assistance. Additionally, the community spouse will receive monthly payments from the annuity and be able to use them however they like.

2. Draft a Life Estate for Your Real Estate

A life estate legally gives ownership to one spouse and gives the other spouse the status of “remainderman,” meaning they are designated to receive the property upon the spouse’s death. Once in effect, a life estate stops state governments from trying to take the property. Whether the spouse passes away in their home or a nursing home, the remainderman inherits the property.

Be aware, however, that a property transfer through a life estate counts towards Medicaid’s asset-transfer look-back period of five years. If the institutionalized spouse passes away within five years of drafting a life estate, the community spouse may be subject to a penalty if the remainder interest is considered a gift. 

3. Purchase Long-Term Care Coverage

Long-term care insurance helps couples meet expenses for an institutionalized spouse with a chronic health condition or problem that renders them unable to care for themselves. However, this coverage is costly when purchased later in life, and you may never use it if you or your spouse don’t go into a nursing home. That said, purchasing long-term care insurance could shrink your assets and help the spouse in the nursing home get Medicaid assistance.

4. Shelter Assets With an Irrevocable Trust

An irrevocable trust – or in this case, a Medicaid trust – may help you remove some assets from your estate.. Ceding control of a significant portion of your assets should only occur for a few reasons: keeping assets from creditors, reducing taxes or becoming eligible for government assistance. Regarding the topic at hand, wealth and assets assigned to an irrevocable trust will not count toward Medicaid qualification, as long as they were placed in the trust at least five years prior. Therefore, irrevocable trusts can help you receive government help for nursing home costs.

However, you should only create an irrevocable trust after considering the pros and cons. You’ll be giving control of most or all of your wealth to a trustee. For example, if you wanted to sell your home and downsize, you would need your trustee to sign off on it. You will also most likely lose access to the funds in the trust and only receive income from the trust’s principal.

A Word of Caution for Protecting Your Assets

How much income the community spouse receives differs between states. Each minor or dependent child living with the community spouse allows a 33% increase to the monthly amount.

Because of the Omnibus Budget Reconciliation Act of 1993, Medicaid can pursue repayment from your estate for nursing home expenses after your death. When you don’t appropriately shelter your assets, it’s available for seizure, which could end up leaving your intended beneficiaries empty-handed.

Asset transfers are also governed by separate tax rules. In 2026, gifts above $19,000 to any one person require filing a gift tax return with the IRS, although filing does not automatically mean tax is owed. These rules operate independently from Medicaid eligibility and often create confusion when families consider gifting strategies.

Medicaid applies its own restrictions through a five-year look-back period. The program reviews gifts and asset transfers made within five years of applying for benefits, regardless of whether they triggered tax filings. Transfers identified during this period can result in a penalty delay before Medicaid coverage begins, which can leave applicants responsible for care costs during that time.

Bottom Line

Planning ahead for the potential of either you or your spouse ending up in a nursing facility is essential for protecting your assets as you age. If it happens, there are ways you can retain your wealth and property by taking action well in advance. From getting long-term care insurance coverage to buying the right annuity, there are ways to put yourself in a better position if this happens to occur.

This type of planning becomes especially important when Medicaid may eventually play a role in covering care costs.

“Medicaid can help cover some gaps in financial coverage for couples where one spouse is living in a nursing home. If you or your spouse are likely to need nursing home care in the next five years, meet with a fiduciary advisor to discuss how you can best organize your assets to provide for both spouses,” said Tanza Loudenback, CFP®.

Tanza Loudenback, Certified Financial Planner™ (CFP®), provided the quote used in this article. Please note that Tanza is not a participant in SmartAsset AMP, is not an employee of SmartAsset and has been compensated. The opinion voiced in the quote is for general information only and is not intended to provide specific advice or recommendations.

Tips on Retirement Planning

• A financial advisor may be able to help you find long-term care options. Finding a qualified financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
• Retirement and long-term care planning aren’t always easy. For help, check out SmartAsset’s Retirement tax calculator which can help you determine the friendliest state to retire in, from a tax perspective.
• It can be confusing trying to figure out how much money you need to have saved at any given time so that you’ll have enough for retirement. You can check out our resource on the average retirement savings by age to learn more and gauge how close you are.

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