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The Community Spouse

What Is A Community Spouse?



One of the most significant benefits of Medicaid Planning is providing for the financial well-being of a spouse that remains living in the community; commonly called the "The Community Spouse".  However, care must be taken to ensure that certain key elements are addressed in the "Protection Plan" when a "Community Spouse" is involved.


These key elements are:

  • Maximizing the amount of the Nursing Home patient's income that the "Community Spouse" can keep.
  • Preserving the assets for the ongoing care of the "Community Spouse".
  • Structuring the Asset Protection Plan in a manner that takes into account the possibility of the "Community Spouse" predeceasing the Nursing Home patient.
  • Planning for Probate avoidance.
  • Eliminating or Minimizing Tax consequences. 

Maximizing the INCOME the "Community Spouse" can keep!

The state of Florida Medicaid guidelines provide Minimum Monthly Maintenance Needs Allowances and Maximum Monthly Maintenance Needs Allowances for the Community Spouse. The term "Allowances" refers to the amount of income the Community Spouse is allowed to keep when the Nursing Home patient's income is added to the Community Spouse's income.


Currently, the Florida Minimum Monthly Maintenance Needs Allowance is $2,114.00.

The Minimum Monthly Maintenance Needs Allowance is the minimum combined income amount, regardless of the costs associated with maintaining the spouse's residence, that Florida Medicaid guidelines allow for the Community Spouse. The Community Spouse is entitled to receive from the Nursing Home patient's income the difference between the Community Spouse's income and the Minimum Monthly Maintenance Allowance as long as the Nursing Home patient's income is sufficient to meet this amount. If the amount of income the Nursing Home patient receives is not sufficient to meet the minimum, then the Community Spouse will ONLY receive the total amount of the Nursing Home patient's income. Medicaid WILL NOT supplement this amount to reach the Minimum Monthly Maintenance Allowance.

To be entitled to more than the Minimum Monthly Maintenance Needs Allowance, proof must be provided detailing the costs associated with maintaining the Community Spouse's residence (Mortgage/Rent, Property Taxes, Property Insurance and HOA dues). The state of Florida Medicaid guidelines set forth a specific formula for calculating the exact amount of Income Diversion (the amount of the Nursing Home patient's income the Community Spouse can keep) the Community Spouse is entitled to receive. This calculation takes into account the Community Spouse's income, the costs associated with maintaining the Community Spouse's residence and the Nursing Home Patient's income. The maximum amount of Income Diversion the Community Spouse may be entitled to receive cannot be greater than the Florida Maximum Monthly Maintenance Needs Allowance less the Community Spouse's income. In other words, the sum of the Community Spouse's income and the Income Diversion from the Nursing Home patient cannot be greater than the Florida Maximum Monthly Maintenance Needs Allowance.

Currently, the Florida Maximum Monthly Maintenance Needs Allowance is $3,216.00.

One final note on income diversion.  Even though there is a maximum allowance, the maximum can actually be increased by Fair Hearing or court order, if a justifiable need can be proven to the satisfaction of the hearing officer or judge.

If this all sounds confusing, understand that this is typical of the Florida Medicaid guidelines. Platinum Benefit Services, Inc. has processed more than 6,000 Medicaid cases. Platinum's staff has the knowledge and experience necessary to prepare the application to Maximize the amount of Income Diversion that the Community Spouse will be entitled to receive.

To find out how much income your loved may be entitled to receive, click "Community Spouse Diversion Calculator" . It's FREE and we DO NOT store your personal information!


Preserving Assets for care of the "Community Spouse".

Our experience has shown that it is very common for the Community Spouse to outlive the Nursing Home patient by many years. Therefore, it is both crucial and prudent to preserve assets for the ongoing care of the Community Spouse. Long Term Nursing Home Care will cost $8,000.00 or more per month; $100,000.00 or more per year. Once the Medicaid application is approved, the only cost associated with the Long Term Nursing Home Care will be the Nursing Home patient's income that remains after the Community Spouse Income Diversion, Nursing Home Patient Health Insurance Premium and Personal Needs allowance are all deducted.

Contingency Plan to Disinherit the Patient if the "Community Spouse" Passes Away First.

The state of Florida Medicaid guidelines provide many different options for structuring assets to qualify for Long Term Nursing Home Care benefits. However, when utilizing these options, multiple scenarios MUST be taken into account for the plan to be a quality long term solution. One of these possible scenarios is the Community Spouse predeceasing the Nursing Home patient. Careful planning must be implemented to ensure that the Nursing Home patient NOT be the beneficiary or recipient of assets from a community spouse's prior demise because receipt of such funds would disqualify the patient from continued Medicaid eligibility. While both the Nursing Home patient and the Community Spouse are alive, the allowable countable asset cap is $128,640.00. If the community spouse dies, the Nursing Home patient is considered an individual applicant and the allowable asset cap for an individual (non-married applicant) is $2,000.00. All account titling, beneficiary designations or other asset ownership titling must be structured in a manner that avoids this trap.  The Medicaid Asset Protection Attorneys on this site will recommend a comprehensive plan that takes into account multiple scenarios for a quality long term solution.

Planning for Probate Avoidance.

One of the numerous benefits of utilizing a Medicaid Asset Protection implementation team for the filing of your Asset Protection Plan is Probate Avoidance. If you or someone you know has has been through the probate process, then you can appreciate the importance of avoiding assets being tied up in the probate courts. The process is arduous, costly and will take months to finally settle.  Further, and more importantly, the Estate Recovery Division of the State of Florida can file a claim against most assets that are subject to statutory probate which, in Florida, can include assets in a revocable living trust.  Your chosen Attorney will prepare a plan that will avoid assets passing through probate and thereby save both money and time.  Platinum will help to administratively carry out the probate avoidance instruction of the Asset Protection Plan.


Tax Efficient Planning

As mentioned earlier, the state of Florida Medicaid guidelines provide many different options for structuring assets to qualify for Long Term Nursing Home Care benefits. It should be noted that some of these options can involve significant tax consequences. Your chosen Medicaid Asset Protection Attorney will discuss tax liability exposure and structure a plan that minimizes, or in many instances, eliminates tax liabilities associated with the Medicaid Asset Protection Plan. 

Platinum's specialist and the attorneys on this site have the knowledge and experience to implement a Medicaid Asset Protection Plan specifically tailored to provide for the long term financial security of the spouse that resides in the community. Remember, Platinum has successfully filed more than 6,000 cases!


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