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Home » Medicaid » An Overview of Medicaid Protections for the Healthy Spouse

An Overview of Medicaid Protections for the Healthy Spouse

December 7, 2021 by Larry Parman, Estate Planning Attorney, Author, Speaker

Medicaid PlanningJust over half of senior citizens will need paid long-term care, and 35 percent of elders will move into nursing homes  at some point.  As you might imagine, nursing home care is very expensive.

In the state of Oklahoma, the average cost for a day in a nursing home is $179.57.  This equates to over $65,500 for a year, and 12 months is the average length of stay.

This is a lot of money to come up with late in your life after many years of retirement.  Medicare does not cover these costs.

Medicaid Eligibility

The Medicaid program covers nursing home care for those eligible.  In fact, most seniors in nursing homes are Medicaid beneficiaries. This benefit is only available to people that can prove they have a significant level of financial need.  The asset limit is $2000.

Allowances for a Healthy Spouse

There are certain Medicaid protections for the healthy spouse. Ordinarily, the disabled spouse’s income is contributed toward the long-term care costs incurred.

This requirement is not enforced if the healthy spouse is relying on the income. He/she can receive a benefit called the Monthly Maintenance Needs Allowance, but there is a maximum threshold.  In 2021, the threshold stands at $3260 in the state of Oklahoma.

The healthy spouse can also maintain possession of half of the couple’s assets up to a certain limit. This is formally referred to as the Community Spouse Resource Allowance.  The maximum limit during the current calendar year is $130,380.

There is also a minimum allowance of $26,076.  A healthy spouse can keep this amount even if it is more than half of the assets.

Home Ownership

A home is not considered a countable asset for Medicaid eligibility purposes, but there is an equity limit. This year, the equity limit is $603,000 in Oklahoma.  However, there is no equity limit when a healthy spouse remains in the home.

Even though you can potentially qualify for Medicaid as a homeowner, it may be wise to avoid it.  For a homeowner, Medicaid could place a lien on the home during the estate recovery phase after your passing.  However, there are some exceptions to the rule.

No lien is attached if your spouse is still residing in the home.  The same rule applies for a minor, disabled, or blind child.  There is also a child caregiver exemption.

As an example, let’s say that your daughter is living in your home with you and providing care.  The level of assistance that she provides allows you to stay in your home.  If she has provided care for at least two years, you can give the home to your daughter, and avoid the Medicaid recovery mandate.

Five-Year Look Back Period

An irrevocable Medicaid trust may also be a good solution.  By conveying your home and other property to the trust, you establish a financial profile leading to Medicaid eligibility.  Under such a trust, you have no access to the principal, but you could accept distributions of the trust’s earnings.

If you apply for Medicaid at some point, the assets in the trust would be shielded, but timing is key. There is a five-year look back period, so you have to fund the trust at least five years before you submit your application for Medicaid coverage.

Schedule a Consultation Today!

Today is the day for action if you need an estate plan.

When you work with us, we will put you at ease and seek to understand your situation and legacy goals.  We will explain your options and provide recommendations so you can make informed decisions.

At the end of the process, you will walk away with a tailor-made estate plan that ideally suits your needs. If you are ready to get started, you can schedule a consultation at our Oklahoma City estate planning office.  Please call us at at 405-843-6100.  Or, use the the contact form on this site to send us a message.

  • Author
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Larry Parman, Estate Planning Attorney, Author, Speaker
Larry Parman, Estate Planning Attorney, Author, Speaker
Founder and Owner at Parman & Easterday
Larry Parman's dad died at 56 in a farm accident with no estate plan. His family spent two years fighting the IRS and nearly three years in probate. That experience became Larry's life work.

Since founding Parman & Easterday in 1985, Larry has led over 1,000 free, community-service education programs and helped more than 10,000 Oklahoma families go from putting off their estate plan to getting it done. His goal for every client is the same: to become the person their family calls "the one who took care of everything."

Larry is the author of three books: The Straight Shooter's Guide to Estate Planning; Estate Planning Basics; and Guiding Those Left Behind in Oklahoma. He served as Oklahoma's Secretary of State and Secretary of Commerce, and his firm is the only member of the American Academy of Estate Planning Attorneys in the state.
Larry Parman, Estate Planning Attorney, Author, Speaker
Latest posts by Larry Parman, Estate Planning Attorney, Author, Speaker (see all)
  • Does Every Estate Go Through Probate? - September 29, 2026
  • TOD Deeds: A Ticking Time Bomb for Real Estate Transfers - September 24, 2026
  • The Challenges of Estate Planning for Child-Free Couples - September 22, 2026

Filed Under: Elder Law, Medicaid Tagged With: Community Spouse Resource Allowance, Medicaid planning, Monthly Maintenance Needs Allowance

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