Q: I’ve been told that if my spouse goes into a nursing home, I could lose our house and most of our income. Is that true?

This is one of the first concerns families raise, and fortunately, the answer is no. Many people come in worried that everything they have worked for will have to be spent down before care can be approved. The reality in New York State is that the law is designed to protect the spouse who remains at home.

When one spouse requires nursing home care, Medicaid recognizes that the other spouse is still living in the community and still needs financial support. The spouse at home, often referred to as the “community spouse,” is not expected to become impoverished just because their partner needs care.

Medicaid Rules for Community Spouses

In 2026, the community spouse is allowed to keep their own income and, if necessary, receive a portion of the nursing home spouse’s income, up to approximately $4,066.50 per month. This is meant to ensure that basic living expenses such as housing, utilities, food, and other day-to-day costs can continue to be paid. For many families, this is an important protection that allows the spouse at home to maintain stability.

There are also important protections when it comes to assets. While the spouse applying for Medicaid is limited to maintain $33,038 in their own name, the spouse at home can retain approximately $74,820, or up to one-half of the couple’s total assets, with a maximum of $162,660. The applying spouse can also have retirement accounts as an additional asset. Beyond that, the primary residence is typically protected as long as the spouse, or minor or disabled child continues to live there. This often comes as a relief to families who are concerned about losing their home.

No Penalty for Asset Transfers Between Spouses

Another important point is that assets can be transferred to a spouse without triggering a Medicaid look-back penalty. This is different from transfers to other individuals, which can result in a period of ineligibility. Because transfers between spouses are allowed, there are often opportunities to protect assets even when planning has not been done in advance.

Spousal Refusal

New York also permits a strategy known as “spousal refusal.” While the name can sound concerning, it is simply a way for the spouse at home to retain assets and income in their own name while the spouse in need of care applies for Medicaid. So long as that document is timely filed with the application, the Medicaid agency will determine eligibility for the institutionalized spouse without considering the assets or income of the community spouse.

Planning Ahead is Key, But Couples Still Have Options

It is also important to understand the cost of care. Nursing homes in the New York area can cost approximately $15,000 per month, and in some cases even more, depending on the facility. Without proper planning, these costs can quickly deplete a family’s savings.

Even in a crisis, families often have more options than they realize. Planning ahead is always best, but there are often still steps that can be taken when care is needed.

By Britt Burner, Esq. and Alma Muharemovic Esq.

Britt Burner, Esq. is the Managing Partner at Burner Prudenti Law, P.C. focusing her practice areas on Estate Planning and Elder Law. Alma Muharemovic, Esq. is an associate attorney at Burner Prudenti Law, P.C. practice on Estate Planning. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.

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