One of the most common fears we hear from families is that qualifying a spouse for Medicaid nursing home coverage means the spouse who stays at home has to give up everything first. That isn't how the rule actually works. Federal spousal impoverishment protections exist specifically to prevent that outcome, and the dollar figures behind them are updated every year — here's where they stand for 2026.
The Community Spouse Resource Allowance
When one spouse applies for Medicaid nursing home benefits, the couple's combined countable assets are assessed and split using formulas set by each state, but every state must protect at least a minimum amount for the spouse who remains at home — the community spouse. For 2026, per the CMS 2026 spousal impoverishment standards bulletin, the Community Spouse Resource Allowance (CSRA) ranges from a minimum of $32,532 to a maximum of $162,660, both effective January 1, 2026. States set their own figure within that federal range, so the exact protected amount depends on where the couple lives.
The Minimum Monthly Maintenance Needs Allowance
Resources aren't the only thing protected — income is too. If the community spouse's own income falls below a set threshold, they're entitled to keep some of the institutionalized spouse's income to make up the difference. For 2026, the Minimum Monthly Maintenance Needs Allowance (MMMNA) is $2,705 per month in every state except Alaska and Hawaii, effective July 1, 2026, while the Maximum Monthly Maintenance Needs Allowance is $4,066.50, effective January 1, 2026 (CMS 2026 bulletin). Alaska and Hawaii have their own higher minimums reflecting local cost of living. See Medicaid.gov's spousal impoverishment page and the National Council on Aging's explainer for how these allowances are actually calculated case by case.
The home isn't forgotten either
Home equity has its own protection tier. For 2026, an applicant's home is exempt from Medicaid's asset test up to a home equity limit of $752,000, with states permitted to raise that ceiling as high as $1,130,000 — both effective January 1, 2026, per the same CMS bulletin. A home occupied by a community spouse is generally exempt from these limits altogether while the spouse continues to live there.
The practical takeaway
These protections exist precisely so that a health crisis for one spouse doesn't become a financial crisis for both. The specific dollar figures change annually and the state-level formulas within the federal range vary, which is exactly why this is a case where getting current, state-specific numbers before an application — not after — makes the biggest difference. Our Medicaid baseline pillar page is a good starting point, and if a spouse's care need feels imminent rather than years away, the crisis planning pillar covers strategies designed to work within these same protections.