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Medicaid when one spouse needs long-term care

How Florida protects the spouse who stays home, and how income above the cap is handled.

Quick answer

DCF's April 2026 standards let the community spouse keep countable assets up to the community spouse resource allowance of $162,660 and receive enough of the applicant's income to reach the minimum monthly maintenance needs allowance of $2,644, or more when shelter costs are high, up to $4,067.

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Last verified: November 2026

What may the spouse at home keep under Florida Medicaid?

DCF's April 2026 standards let the community spouse keep countable assets up to the community spouse resource allowance of $162,660 and receive enough of the applicant's income to reach the minimum monthly maintenance needs allowance of $2,644, or more when shelter costs are high, up to $4,067.

The home, one vehicle and personal belongings are generally not counted. The maintenance figures update each July 1, and the resource and home-equity figures each January 1.

What is a qualified income trust?

A qualified income trust (often called a Miller trust) is an irrevocable trust that an applicant with gross income above $2,982 a month funds with the excess each month, so that Florida's income cap is met for nursing home or home and community-based Medicaid.

The State of Florida must be named to receive what is left in the trust at death, up to the amount Medicaid paid. A month without a deposit can mean a month without eligibility.

How do Florida's look-back and transfer penalty work?

DCF reviews gifts and other transfers for less than fair value in the 60 months before an application and divides their value by a penalty divisor, $10,645 in its current table, to set the months of ineligibility for nursing home care.

Transfers to a spouse, and certain transfers to a disabled child, carry no penalty. A penalty period begins only once the person is otherwise eligible and needs care.

When is an elder law attorney worth the cost?

When there is a spouse at home, income above the cap, a home or small business to protect, or gifts made in the last five years, because errors in timing can cost months of coverage.

The Florida Bar's lawyer referral service can suggest elder law attorneys, and legal aid programs help some low-income seniors free of charge.

May the spouse at home keep the car and the house?

Generally yes: one vehicle, the home where the community spouse lives, household goods and personal effects are excluded from countable assets for Florida Medicaid, along with certain burial funds.

Other real estate, a second car and investment accounts usually count.

Side by side

Florida's spousal rules protectFlorida's spousal rules do not protect
SavingsUp to $162,660 for the spouse at homeEvery dollar the couple has
IncomeA maintenance allowance of up to $4,067All of the applicant's income
GiftsTransfers between spousesGifts to others within 60 months

Built from Chapters 408, 429 and 651, Florida Statutes; Florida Administrative Code chapters 59A-36 and 65A-2; AHCA, DCF, OIR and Department of Elder Affairs publications; and the CareScout and VA rate tables cited on this page. Our editorial standards explain how each figure is checked.

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