The high cost of long-term care in a nursing home makes paying the bill almost impossible for most people. As a result, many people apply for Medicaid to cover the expenses. However, if you and your spouse own your home and a number of assets,  you may be able to afford the expenses yourself…for a short time.

If you must use your own assets to pay for the care, you will not be able to continue to live in your home or enjoy a reasonable standard of living. Pennsylvania laws include Spousal Impoverishment rules so that you do not lose your income and resources when your spouse enters a nursing home.

Assessment of resources

You and your spouse will need to have your resources assessed in order to determine how much you each may keep. Your portion is at least half of the spousal countable resources, although the amount is subject to the current spousal share for spousal impoverishment. As of Jan. 1, 2019, this amount is between $25,284 and $126,420.

The assessment must be for the value of the resources as of the day that your spouse applies for medical assistance and receives admission to a nursing home facility, or the day he or she receives admission to the facility for 30 or more continuous days.

Reduction of resources

As the community spouse, you may keep resources that are below the current resource limit for your spousal share. Your spouse’s resources above the limit for receiving medical assistance must go toward the following:

  • Payment of the nursing home
  • Payment of other medical bills
  • Purchase of an irrevocable burial reserve
  • Purchase of personal items for you and/or your spouse

If you and your spouse spend any of his or her additional resources on something other than these approved expenditures, it could retroactively affect medical assistance eligibility.