• Kathy L. McNair, Esq.

Protecting Assets When Your Spouse Needs Nursing Home Care in 2020


When your spouse needs nursing home care, it can be a very stressful and emotional time. You should not have to worry that you will lose your life savings paying for your spouse’s nursing home care. By getting the right advice as soon as possible, you may have options to protect your assets.


Nursing homes in Massachusetts are extremely expensive and often cost $150,000 per year or more. The Medicaid program (called “MassHealth” in Massachusetts) helps pay for nursing home care for individuals who meet certain asset and income requirements. MassHealth provides special protections for the applicant’s spouse to make sure that he/she is not impoverished paying for nursing home care.


Asset Limits in Massachusetts

In Massachusetts, in order to be eligible for MassHealth benefits a nursing home resident may have no more than $2,000 in assets, but if the spouse is still able to live at home (or in an assisted living facility), then the spouse at home may keep up to a maximum of $128,640 (in 2020). This is called the "spouse living at home resource allowance”. Usually, the home is not included when determining this amount.

If your spouse needs nursing home care, and you have more than $128,640, it is critical that you meet with an Elder Law attorney to help you protect your excess assets. At Senior Solutions, our attorneys have helped many clients who have had assets over this amount, protect assets for the spouse still living at home. However, it is critical that you get the right advice as soon as possible. Each day that you wait could cost you hundreds of dollars. After meeting with our clients, we provide a written plan to serve as a step by step guide on protecting assets for the spouse at home. We help our clients through this process and help them apply for MassHealth benefits for their spouse.


Income Limits in Massachusetts

In Massachusetts, the income of the spouse living at home is not counted in determining the MassHealth applicant’s eligibility. Only income in the applicant’s name is counted. However, the spouse in the nursing home must contribute almost all of his income toward the cost of his care.


But what if most of the couple’s income is in the name of the spouse in the nursing home and the spouse living at home’s income is not enough to live on? In this case, the spouse living at home is entitled to some or all of the monthly income of the spouse in the nursing home. How much the spouse living at home is entitled to depends on what the MassHealth agency determines to be a minimum income level for the spouse living at home. This figure, known as the minimum monthly maintenance needs allowance or MMMNA, is calculated for each spouse living at home according to a complicated formula based on his or her housing costs. The MMMNA may range from a low of $2,113.75 to a high of $3,216 a month (in 2020). If the spouse living at home’s own income falls below his or her MMMNA, the shortfall is made up from the nursing home spouse’s income.


  • Example: Joe and Sally have a joint income of $3,000 a month, $2,500 of which is Joe’s and $700 is in Sally’s name. Joe enters a nursing home and applies for MassHealth. The MassHealth agency determines that Sally’s MMMNA is $3,000 (based on her housing costs). Since Sally’s own income is only $700 a month, the MassHealth agency allocates $2,300 of Joe’s income to her support. Since Joe also may keep a $72.80-a-month personal needs allowance, his obligation to pay the nursing home is only $127.20 a month ($3,000 - $700 - $72.80 = $127.20).


If the spouse living at home (or in an assisted living facility) has significant expenses for her own medical care, then we can help you seek an increase in the income allowance by filing an appeal with the MassHealth Board of Hearings.


MassHealth rules provide opportunities for nursing home residents to preserve assets for their spouse. Spouse’s don’t need to plan five years in advance to protect assets for each other. Even if your spouse needs nursing home now, we can usually help protect your assets. It's always worth checking out whether these are steps you can take to protect your assets.


The attorneys at Senior Solutions have been helping clients with Medicaid planning for over twenty years. We will examine your specific circumstances and provide you with the best strategy for you. We are ready to help, please call us at 617-489-5900 or email me at kmcnair@seniorsolutionsinfo.com.

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