Health & Benefits

A “community spouse” is someone who lives in the community and is married to a person who resides in a nursing home. In other words, the spouse plans to stay in the community, not move into residential care. 

The amount of non-exempt assets a community spouse can keep is called the Community Spouse Resource Allowance (CSRA). This is an amount that is set by IDHS and can change every year. 

As of January 1, 2026, the community spouse may keep up to $143,172 in non-exempt assets.

A Medicaid recipient living in a nursing home who qualifies under the Aid to the Aged, Blind, and Disabled (AABD) program may keep up to $17,500 in non-exempt assets.

Yes. The spouse in the nursing home may transfer assets to the community spouse up to the CRSA limit without penalty. However, the transfer must happen before the first redetermination of benefits after the nursing home resident is initially approved for LTC Medicaid benefits. The first redetermination typically occurs one year following the initial approval. 

Any assets above $17,500 that remain jointly or individually owned by the spouse in the nursing home at the time of IDHS’ first redetermination of Medicaid benefits will be considered to be available to the nursing home spouse to pay for their care in the nursing home.

Example

Bob lives in a nursing home. His wife, Mary, lives at home. Mary is the community spouse. They have the following assets:

• Bob has a $40,000 certificate of deposit (CD).
• Mary has a $20,000 savings account.
• They have a joint savings account with $10,000.

Together, they have $70,000 in assets. Because this amount is less than the CSRA limit of $143,172, Bob may transfer his assets to Mary within the first year that he resides in the nursing home. Once the assets are transferred to Mary, Mary may keep the assets and will not be required to spend them down.

As of January 1, 2026, nursing home residents may keep $60 per month of income to cover personal needs. A nursing home resident who receives veterans benefits may keep $90 per month.

The Community Spouse Maintenance Needs Allowance (CSMNA) is the amount of a nursing home spouse’s monthly income that the community spouse is allowed to keep to help provide for the community spouse’s needs and expenses.

As of January 1, 2026, the community spouse may keep the nursing home spouse’s income of up to $4,066.50 per month after subtracting any other income earned by the community spouse. If the community spouse has individual income equal to or higher than $4,066.50, they may not receive any allowance amount.

Yes. If the community spouse's income is below the CSMNA limit, the spouse in the nursing home may transfer income to them until the spouses’ combined income reaches that limit.

Example #1

Bob lives in a nursing home. His wife, Mary, lives at home. Mary is the community spouse.

Bob receives:

• $900 per month from Social Security
• $200 per month from a pension

Mary receives:

• $500 per month from Social Security

Mary's income is below the CSMNA limit of $4,066.50. Because of this, Bob may transfer income to Mary. In this example, he may transfer all of his income because their combined monthly income is only $1,600.

Example #2

Joyce lives in a nursing home. Her husband, John, lives at home. John is the community spouse. 

Joyce receives:

• $3,200 per month from Social Security 

John receives:

• $1,300 per month from employment

Their combined income is $4,500 per month.

John’s income is below the CSMNA of $4,066.50, however the couple’s combined income is more than $4,066.50. Joyce may transfer up to $2766.50 of her income to John. This is the CSMNA limit of $4,066.50 minus their combined income of $4,500. Joyce may also keep $60 to pay for her own needs, and she must pay the remainder of any non-exempt monthly income to the nursing home.