Special Income Rules


Many family's fear the Medicaid application because they assume that all of the sick spouse's income must be paid to the nursing home and the spouse at home will not have enough income to live. 

Fortunately, there are certain laws that protect the income of married persons so the community spouse doesn’t face destitution. Community spouse income allowance is based on several factors, which with effective planning are optimized for your benefit. 

Special Income Rules 

The non-disabled spouse living at home is guaranteed a minimum income of $2,465 per month and up to $3,853.50 per month maximum.

This means that if the spouse at home has a smaller income than the minimum income amount, the patient's income is diverted to the spouse rather than being applied to the patient's care bill. In addition to the minimum income amount, there is an additional allowance for the spouse's shelter expenses. 

Shelter Allowance

If the community spouse qualifies, he or she receives a shelter allowance to the extent that their monthly shelter expenses exceed $739.50.

Shelter expenses include:
  • Rent
  • Condo maintenance charges
  • Land contract
  • Mortgage payments
  • Property taxes
  • Assessments
  • Homeowners insurance

Heating And Utility Allowance

In addition to the shelter allowance, there is a heating and utility allowance for the community spouse of $620 per month. However, if your shelter expenses exceed $739.50, the excess amount will be added to the minimum income allowance of $2,465 per month. Keep in mind that the income allowance for the community spouse cannot exceed $3,853.50 per month.

Total Spousal Income Allowance

Once the total spousal income allowance has been determined, the community spouse’s own monthly income is deducted from the total allowance. The remaining sum is the amount that is diverted from the income of the patient spouse to the community spouse. If the community spouse’s own income is greater than the income allowance, then all of the patient spouse’s income will be applied to the patient pay amount.

There is no limit on the amount of income that can be earned by the community spouse. Other than determining whether the community spouse is entitled to an income allowance, the community spouse’s income is never used to pay for the patient spouse’s nursing home care.

Before you apply for Medicaid, consult with our elder law attorney to learn how special income rules for married persons affect you and your spouse. 

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