Worcester Senior AdvisorBy Worcester Senior Advisor Care Team · October 5, 2026
In 2026 MassHealth lets the spouse at home keep between $32,532 and $162,660 in countable assets and receive between $2,705.00 and $4,066.50 a month from the nursing home spouse's income, while the resident keeps $72.80 a month. Planning before the application is what protects the most.
Why couples face different rules
When a single person needs long-term nursing home care, MassHealth's rules are blunt: countable assets above $2,000 must be spent before coverage starts, and most income goes toward the cost of care. When the person is married, federal spousal impoverishment rules protect the spouse who stays at home, so that one person's care does not leave the other without enough to live on.
The 2026 numbers
| 2026 MassHealth figure | Amount |
|---|---|
| Nursing home resident's asset limit | $2,000 |
| Resident's personal needs allowance | $72.80 a month |
| Community spouse resource standard, minimum | $32,532 |
| Community spouse resource standard, maximum | $162,660 |
| Monthly maintenance needs allowance, minimum (from July 1, 2026) | $2,705.00 |
| Monthly maintenance needs allowance, maximum | $4,066.50 |
| Home equity limit | $1,130,000 |
| Average daily nursing facility cost used for transfer penalties (from Nov. 1, 2026) | $469 |
Source: MassHealth's program financial guidelines, updated October 1, 2026.
How the protections work in practice
The couple's countable assets are added up as of the date the spouse entered the nursing home. The spouse at home keeps a share within the minimum and maximum above, and the rest must be spent down or otherwise accounted for before the resident qualifies. The home, a car and some other items are generally not counted while the spouse lives at home.
On the income side, if the spouse at home has little income of their own, part of the resident's income can be directed to them, up to the maintenance allowance. Shelter costs above a standard amount can raise the allowance.
What to take to an elder law attorney
Bring a list of every account with its current balance and ownership, recent statements for the past five years, the deed to the house, life insurance policies with cash value, and both spouses' income sources. MassHealth reviews transfers made in the five years before applying, so do not move money or retitle property before getting advice.
Ask specifically how spending on the home, a car or prepaid funeral arrangements would be treated, and whether an application should be filed now or after a particular date.
A simplified example
Suppose a couple in Holden has $250,000 in countable assets when the husband enters a nursing home, plus their home, where the wife will keep living. Under the 2026 maximum, the wife could keep up to $162,660 of those assets, and the husband could keep $2,000. The remainder would need to be spent on his care or on permitted purchases before he qualifies, unless planning changes the picture.
If the wife's own income were $1,500 a month, part of the husband's income could be directed to her to bring her up toward the monthly maintenance allowance. The actual figures depend on the snapshot date, shelter costs and other details, which is why this is an example, not advice.
Mistakes that cost couples money
Giving money to children shortly before applying, which can trigger a penalty period under the five-year look-back. Paying a relative for care without a written agreement. Selling the house without considering how the proceeds will count. Assuming a joint account belongs only to the healthy spouse. And waiting until the last month to apply, when a few weeks of preparation could have changed the result.
Each of these is avoidable with advice before acting. Many Massachusetts elder law attorneys offer an initial consultation, and councils on aging can suggest local names.
When the spouse at home also needs care
Couples sometimes face care needs for both spouses at once. If the spouse at home later needs home care, the Frail Elder Waiver and the state Home Care Program apply their own rules to that spouse, and the assets protected for them under the spousal rules still count toward their own eligibility. If both spouses eventually need nursing home care, the spousal protections no longer apply in the same way. An elder law attorney can map out the sequence, including whether assisted living for the healthier spouse is affordable over several years.
Frequently asked questions
Does the spouse at home lose the house?
Generally no while the spouse lives there, but estate recovery and the home equity limit matter later.
Can the spouse at home keep their own income?
Yes. Their own income is theirs; the allowance can add to it from the resident's income if it is low.
When should we apply?
Get advice first, then apply as soon as the planning is done; long-term care applications take time.
Does MassHealth count retirement accounts?
Often yes, though treatment depends on the type of account and whether it is in payout status; ask an attorney.
What is estate recovery?
MassHealth may seek repayment from a deceased member's estate for certain long-term care costs, subject to exceptions such as a surviving spouse.
Does MassHealth look at the healthy spouse's assets?
Yes. For long-term care, the assets of both spouses are counted together at the snapshot date, and the spouse at home then keeps a protected share.
