Staying Eligible for Medicaid after the Death of a Spouse

When one member of a couple moves to a nursing home, we expect that spouse will be the first to die, but this isn’t always the case. What happens if a Medicaid recipient’s spouse dies first? If planning steps are not taken, the death of a spouse can affect the nursing home resident’s assets and eligibility for Medicaid.

In order to be eligible for Medicaid benefits, a nursing home resident may have no more than $2,000 in assets. The Medicaid applicant’s spouse (called the “community spouse”) can keep more assets. In general, the community spouse may keep one-half of the couple’s total “countable” assets up to a maximum of $137,400 (in 2022). Often when one spouse seeks to qualify for Medicaid, he or she transfers assets to the community spouse.

The death of a Medicaid recipient’s spouse can affect the amount of assets the Medicaid recipient has, and therefore his Medicaid eligibility. For example, suppose a community spouse dies, and her will leaves her estate to her husband, who is in a nursing home and receiving Medicaid. The additional assets may make the husband ineligible for Medicaid. Even if the community spouse’s will did not leave anything to her husband, he may be entitled to claim a share of the estate. Medicaid can assess a penalty even if the husband does not claim his share.

The couple’s house can also become a problem. Most spouses own property jointly with a right of survivorship. If the community spouse dies, the Medicaid recipient will own the house. The nursing home resident must show intention to return home in order for the house not to count as an asset. If the resident sells the house, the proceeds from the sale will make the resident ineligible for Medicaid.

To prevent a community spouse’s death from affecting the institutionalized spouse’s Medicaid eligibility, it is important that the community spouse update his or her estate plan. There are steps the community spouse can take to protect the spouse in the nursing home, including setting up a trust. To find out the plan that would work best for you, contact us.






The information contained on this website is intended as an overview on subjects related to the practice of law. Each individual case is different, and laws do change, so please be aware that the circumstances and outcomes described may not apply to all cases and should not be interpreted as legal counsel. Please seek the advice of an attorney before making any decision related to legal issues.