Protecting the Spouse at Home: Florida Medicaid Community Spouse Rules

The community spouse may keep countable assets up to $162,660. Florida uses the federal maximum for every couple, rather than a share of the couple's assets, so a couple with $200,000 in savings can protect $162,660 for the spouse at home, leaving about $35,340 to spend down, and the applicant's $2,000. The allowance is in addition to the exempt assets: the home, one vehicle, personal property, a prepaid funeral, and the community spouse's own IRA or 401(k).

All of the couple's countable assets are pooled for this calculation regardless of whose name is on them. A prenuptial agreement does not change it.

The community spouse is entitled to a minimum monthly income. In 2026 the floor is $2,705, and it rises, up to $4,066.50, when the spouse's housing costs (rent or mortgage, taxes, insurance, condominium fees, and a standard utility allowance) exceed a shelter standard. If the community spouse's own income is below the allowance, the shortfall is diverted from the nursing home spouse's income before patient responsibility is calculated. A community spouse with $1,400 of Social Security and a high mortgage might receive $2,000 or more a month from the institutionalized spouse's income, money that would otherwise go to the facility.

Where even the maximum allowance is not enough, the community spouse can seek a higher figure at a fair hearing or through a court support order.

A couple with countable assets above $162,660 plus $2,000 has several lawful options beyond simply spending the excess on care:

• A Medicaid-compliant annuity converts the excess into an income stream for the community spouse. It must be irrevocable, non-assignable, actuarially sound, and name the State of Florida as a remainder beneficiary. This is the most common tool for protecting a large excess, and it is legal work.
• Spending on the community spouse: paying off the mortgage, repairing the house, replacing the car, prepaying a funeral for both spouses.
• Spousal refusal. Florida permits the community spouse to refuse to make their assets available to the applicant. The applicant becomes eligible based on their own assets, and the state may pursue the refusing spouse for support. Used carefully, with an attorney, it protects assets in situations where nothing else will.

The homestead is exempt without any equity limit when the community spouse lives in it. It should stay in the couple's names, or be reviewed by an attorney before any change. If the community spouse dies first, the home and the assets that were protected for them can pass back to the Medicaid spouse and end eligibility; a community spouse's estate plan should be updated when the other spouse goes on Medicaid, which is one of the steps most often missed.

The community spouse's own income is never counted toward the applicant's income cap and is never required to be paid to the facility. Only the applicant's income is subject to the $2,982 cap and the Qualified Income Trust rule.