What are Spousal Impoverishment Rules?

Since 1998, a spouse of a nursing home resident on Medicaid is allowed to keep a reasonable level of income and resources to live on, while still permitting Medicaid payment for the nursing home resident’s care.  Congress enacted the “spousal impoverishment protections” in 1988 in response to stories of elderly “community” spouses — mostly women — whose husbands were in nursing homes.  Medicaid required all of the husband’s income to be paid to contribute to the cost of care.  Some  were practically starving.  Others sought divorces in order to escape the crushing financial burden.    An important sidelight of this legislation was that it permitted states to budget couples on home-and-community-based services (HCBS) “waiver” programs under these same income and asset rules, giving these couples a much-needed financial cushion. 

Which Married Couples Can Use Spousal Impoverishment Protections?


Since the 1980’s, spouses of New Yorkers receiving services through the …
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Spousal Impoverishment Protections for Married Couples where One Spouse is in a Managed Long Term Care Plan – Pooled Trusts Allowed as an Option