Planning for Spousal Support When Your Partner Enters a Nursing Home

When a spouse needs nursing home care, the emotional and financial stress can feel overwhelming. The high cost of nursing homes — often over $7,000 per month — can quickly drain your savings and leave the healthy spouse at risk of financial insecurity. A Northborough elder lawyer can help you navigate Medicaid planning to protect your assets and secure your future.

The Financial Impact of Nursing Home Care

Long-term care is one of the largest expenses many families face. Without proper guidance, these costs can rapidly reduce retirement savings and leave the community spouse in a difficult position. Many couples seek Medicaid assistance, but qualifying can be complex, especially when one spouse remains at home. A Northborough elder law lawyer can explain Medicaid’s spousal impoverishment protections and help you make sense of the rules designed to prevent financial hardship.

Understanding Medicaid’s Spousal Impoverishment Rules

Medicaid uses specific terms to describe each spouse. The partner living at home is called the "community spouse," and the spouse in the nursing home is the "institutionalized spouse." The community spouse is allowed to keep a certain amount of the couple’s assets and income to support themselves.

Asset Protections

Medicaid divides assets into:

• Countable assets — like bank accounts, stocks, and vacation properties.
• Exempt assets — such as a primary residence, one vehicle, and personal belongings.

The Community Spouse Resource Allowance (CSRA) allows the healthy or community spouse retain a portion of the married couples assets. As of 2025 in Massachusetts, the community spouse can retain up to $157,920 in countable assets (though this figure varies annually). The institutionalized spouse must reduce their countable assets below $2,000 to qualify.

Income Protections

Medicaid allows the community spouse to keep a portion of income, known as the Minimum Monthly Maintenance Needs Allowance (Minimum MMNA). This helps ensure they can meet living expenses. These rules ensure that the healthy spouse does not become impoverished while the other spouse receives nursing care.

How a Northborough Elder Law Lawyer Can Help Protect Spousal Support

Navigating Medicaid eligibility and preserving assets requires thoughtful planning. A Northborough elder law lawyer can guide you through legal strategies such as:

• Asset Transfers — Transferring certain assets to the community spouse, following Medicaid’s five-year look-back rules, can help meet eligibility requirements.
• Medicaid Asset Protection Trusts — These trusts can remove assets from Medicaid’s countable resources, preserving wealth while helping the institutionalized spouse qualify for benefits.
• Spending on Exempt Assets or Debt — Using funds to pay off debt or invest in exempt assets like home repairs or a vehicle can benefit the community spouse and reduce countable assets.

Plan Ahead for Peace of Mind

The best time to consult a Northborough elder law lawyer is before a crisis occurs. Early planning allows couples to create a long-term care strategy that aligns with their goals and protects their finances. Medicaid planning not only ensures eligibility but also helps both spouses maintain dignity, independence, and quality of life during a difficult time.

Key Points to Remember

• Plan early to protect assets and support both spouses.
• Understand Medicaid’s special rules that help prevent spousal impoverishment.
• Work with a Northborough elder law lawyer to explore trusts, asset transfers, and spending strategies.
• Stay informed so you can make the best decisions for your family’s future.

At Kristine Romano Law, our team is here to guide you through the complexities of elder law and Medicaid planning with compassion and care. As many of our clients share, we provide clear guidance and dedicated support every step of the way. If your spouse will need nursing care soon, contact our office to schedule a consultation to learn how we can protect your assets and preserve your legacy.

Reference: Paying for Senior Care (Jan. 17, 2024) “What Happens When My Spouse Enters a Nursing Home?”