Medicaid Spousal Protection: Keeping the House, Car, and Savings When a Spouse Needs Long-Term Care

Medicaid’s spousal impoverishment protections let the at-home spouse shield the house, a car, and six figures in savings while the institutionalized spouse earns Medicaid long‑term care coverage. Key components are the Community Spouse Resource Allowance (CSRA) and the Minimum Monthly Maintenance Needs Allowance (MMMNA), with several assets exempt from countable assets. A snapshot of assets is taken when the ill spouse enters care, the community spouse’s protected share is calculated, and the remainder is spent down. Be mindful of a five‑year lookback on transfers, state-by-state variations, and potential estate recovery after both spouses die. The rules can provide real income for the protected spouse, but due to complexity and annual changes, consult an elder‑law attorney before acting.