Medicaid Planning for the Healthy Spouse
Understanding how Medicaid rules impact a healthy spouse is vital for protecting assets and ensuring a comfortable standard of living. If you are married, understanding how Medicaid rules impact a healthy spouse is vital for protecting assets and ensuring a comfortable standard of living.
This post will provide an overview of Medicaid planning and the provision for the community spouse.
Why Medicaid Becomes Relevant
Medicare is a familiar safety net for many seniors. Medicare is a health care program that does not cover long-term care, including assistance with daily tasks in a nursing facility or at home. This gap can leave families exposed to significant expenses if long-term care becomes necessary.
Medicaid, unlike Medicare, does cover long-term care costs, including nursing home expenses and in-home custodial care. However, Medicaid is a need-based program with strict financial eligibility requirements that can complicate access for middle-income families.
Nursing Home Costs in Oklahoma
Nursing home costs in Oklahoma are substantial. In 2024, Oklahoma City’s average cost of nursing home care will be just under $97,000 per year. With the length of stay exceeding one year for many residents, these costs can deplete a family’s savings quickly.
This makes Medicaid planning an essential strategy for protecting assets and ensuring care is available when needed.
Medicaid Rules and the Healthy Spouse
Medicaid eligibility focuses on the applicant’s income and countable assets. However, special provisions exist to protect the financial security of a healthy spouse who remains at home, known as the “community spouse.”
Countable Asset Limit
The Medicaid applicant must meet a strict countable asset limit, which is $2,000 in Oklahoma. However, certain assets, including a primary residence, are exempt from this calculation.
In 2025, the home equity limit is $730,000. Importantly, if a community spouse continues to reside in the home, there is no equity limit for Medicaid eligibility.
Community Spouse Resource Allowance (CSRA)
To protect the community spouse, Medicaid allows them to retain a portion of the couple’s countable assets, referred to as the Community Spouse Resource Allowance (CSRA). For 2025, the CSRA ranges from a minimum of $31,584 to a maximum of $157,920.
Monthly Maintenance Needs Allowance (MMNA)
Income rules for Medicaid also include protections for the community spouse. The institutionalized spouse must pay for the cost of the care. However, the community spouse can retain a portion of the institutionalized partner’s income under the Monthly Maintenance Needs Allowance (MMNA). However, the community spouse can retain a portion of the institutionalized spouse’s income under the Monthly Maintenance Needs Allowance (MMNA).
For 2024, the maximum allowance has been $3,948, and there is no minimum allowance in Oklahoma though there are minimums in some states.
Planning Ahead: Medicaid Trusts
An essential aspect of Medicaid planning is preparing in advance to meet financial eligibility requirements. A Medicaid trust can be used as a strategy. Assets placed in this trust are not accessible to the grantor but the income from the trust may be available to them until Medicaid benefits are required. Transfers to a Medicaid Trust made within five years before applying for benefits may trigger penalties and delay eligibility. For this reason, proactive planning is critical.
Medicaid Estate Recovery
Another key consideration is Medicaid’s estate recovery program. The state can recover the cost of Medicaid care from the estate of a deceased Medicaid beneficiary. Medicaid estate recovery cannot target the primary residence while the surviving spouse remains alive.
However, if the home is still part of the estate after the death of the community spouse, it may be subject to recovery. Visit our testimonials page
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If you’re ready to take that final step, we can help. Call us at 405-843-6100 to schedule a consultation in our Oklahoma City estate planning office. Call us at 405-843-6100 for a consultation in our Oklahoma City estate-planning office.
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