Spousal Impoverishment Protection (Medicaid) — CSRA
Federal Medicaid rules let the at-home spouse keep up to $162,660 in assets and at least $2,555/month in income when the other spouse needs nursing home care.
Official source: medicaid.gov
Spousal Impoverishment Protection is a federal Medicaid rule that protects the spouse who stays at home, called the community spouse, when the other spouse enters a nursing home and applies for Medicaid. The community spouse keeps a meaningful share of the couple's assets and income so they are not left with nothing.
The Community Spouse Resource Allowance, or CSRA, is the amount of assets the community spouse can keep. For 2026, federal law sets the range between $32,532 and $162,660. Each state picks its own figure inside that range. Assets above the allowance generally must be spent down before Medicaid begins paying for the institutionalized spouse.
Most financial assets count toward the CSRA, including bank and investment accounts and second homes. The primary residence is generally exempt and the community spouse can keep it indefinitely.
Income is protected separately. The Minimum Monthly Maintenance Needs Allowance, or MMMNA, lets the community spouse keep at least $2,555 per month in 2026 and up to $3,854. If the community spouse's own income is below the state's MMMNA, some of the nursing home spouse's monthly income can be redirected to the community spouse to bring them up to the threshold.
These protections are not automatic. The community spouse must request the resource and income allowances as part of the Medicaid application. An elder law or Medicaid planning attorney can help document assets and income accurately so the maximum allowed protection is claimed.
In real life
- A couple has $200,000 in combined assets. The husband enters a nursing home and applies for Medicaid. In a state that uses the federal maximum, the wife keeps $162,660 as her CSRA. The remaining $37,340 must be spent down before Medicaid coverage begins for the husband.
Also known as
Frequently asked questions about Spousal Impoverishment Protection (Medicaid)
+
+
+
+
+
Source: medicaid.gov