Nursing Home Planning for Married Couples in California
Protecting the spouse at home while helping the nursing home spouse qualify for Medi-Cal.
When one spouse enters a nursing home and the other remains at home, Medi-Cal planning is not only about qualifying the nursing home spouse. It is also about preserving enough savings and income for the spouse at home to live with dignity. California law provides important protections — and in the right case, a court petition can protect far more than the standard rules allow.
On this page
The institutionalized spouse and the community spouse
California Medi-Cal uses two terms throughout the married-couple rules. Understanding them makes everything else clearer.
The institutionalized spouse
The spouse who enters a nursing home or skilled nursing facility and applies for Medi-Cal to help pay for that care.
The community spouse
The spouse who remains at home — sometimes called the “well spouse” or “spouse at home.” California law applies special protections so this spouse is not left without resources or income.
These protections exist because of a federal framework often called spousal impoverishment protection. Congress recognized that it would be unfair to require a couple to exhaust everything before one spouse could receive nursing home benefits, leaving the other spouse impoverished. California implements these protections through its own rules and dollar figures.
What savings can the spouse at home keep?
This is usually the first fear: “Do we have to spend everything before Medi-Cal helps?” The answer, for a married couple, is no.
The spouse at home is entitled to keep a protected amount of the couple’s countable assets, known as the Community Spouse Resource Allowance (CSRA). In 2026, the CSRA allows the community spouse to retain up to $162,660 in countable assets. This is in addition to assets that are entirely exempt and do not count at all.
| 2026 married-couple figure | Amount |
|---|---|
| Community Spouse Resource Allowance (CSRA) | $162,660 |
| Countable asset limit for the institutionalized spouse | $130,000 |
| Family home (community spouse residing) | Generally exempt |
| One vehicle | Exempt |
| Personal and household belongings | Exempt |
The couple’s countable assets are generally measured as of a snapshot date — typically the first day of the first month the institutionalized spouse begins a continuous period of institutionalization. Proper planning around that date can matter a great deal. The characterization of each asset — countable versus exempt — is highly fact-specific, and retirement accounts in particular are treated differently depending on whose name they are in and whether they are in payout status.
For the full asset-by-asset breakdown, see our guide to Medi-Cal Asset Limits and Eligibility →
How income is protected for the spouse at home
Assets are only half the picture. The income side is where married couples are most often surprised — and where the most money is sometimes at stake.
When the institutionalized spouse qualifies for Medi-Cal, most of that spouse’s monthly income must generally go toward the cost of care. This required monthly contribution is called the share of cost. The community spouse, however, is entitled to keep his or her own income — and in many cases, some of the institutionalized spouse’s income as well.
The protected income floor for the spouse at home is called the Minimum Monthly Maintenance Needs Allowance (MMMNA). In 2026, the MMMNA is $4,066.50 per month. If the community spouse’s own income is below that figure, some of the institutionalized spouse’s income may be allocated to bring the community spouse up to the MMMNA.
The “name on the check” rule catches many couples off guard
Medi-Cal generally treats income as belonging to the spouse whose name is on the check — the Social Security payment, the pension, the IRA distribution. If the larger income streams are in the nursing home spouse’s name, that income is treated as the institutionalized spouse’s income and flows toward share of cost, even if the couple has always deposited it into a joint account and used it to run the household together.
When the standard protections are not enough
For many California couples, the standard MMMNA of $4,066.50 simply does not cover the real cost of running a household.
By the time the spouse at home pays the mortgage or rent, property taxes, homeowner’s insurance, utilities, food, prescriptions, healthcare premiums, and transportation, $4,066.50 is often not enough — particularly in higher-cost areas of California. When the larger income streams are in the institutionalized spouse’s name, the spouse at home can be left with far too little while a large share of cost is paid to the nursing home each month.
This is the problem that the standard rules do not solve on their own. Fortunately, California law provides a remedy.
The court remedy: a Probate Code §3100 petition
California Probate Code §3100 allows a spouse to petition the Probate Court for an order reallocating income — and in some cases resources — from the institutionalized spouse to the community spouse. When the court grants the order, the allocation to the spouse at home increases, and because share of cost is calculated after that allocation, the share of cost goes down. There is no statutory cap on what the court may award; in appropriate cases, courts have ordered that the spouse at home keep substantially all of the couple’s combined income.
This is where careful legal planning can preserve thousands of dollars per month for the spouse at home — often the single most valuable step a married couple can take.
A worked example: keeping the savings and the income
Consider a married couple we will call James and Carol. James, age 78, has had a stroke and now needs skilled nursing care. Carol, 75, remains at home.
James and Carol’s situation
At the time James enters the nursing home, the couple owns their home (where Carol lives), one car, about $310,000 in savings and a CD, a $240,000 IRA in James’s name, and a $90,000 IRA in Carol’s name. James receives $4,800 per month in Social Security and a pension. Carol receives $1,500 per month in Social Security.
| Without planning | With our planning | |
|---|---|---|
| Countable savings | Spent down before qualifying | Largely preserved within the CSRA |
| The family home | At risk through forced spend-down pressure | Retained; Carol stays in her home |
| Carol’s monthly income | Limited to the standard $4,066.50 floor | Increased through a §3100 petition |
| James’s care | Delayed until assets exhausted | Qualified for Medi-Cal |
Through proper structuring of the couple’s countable assets and a Probate Code §3100 petition to increase Carol’s income allocation, James qualified for nursing home Medi-Cal while Carol preserved her home, kept savings within the protected allowance, and retained monthly income well above the standard minimum.
Every case depends on its own facts. This example illustrates how the married-couple rules and a §3100 petition can change the outcome; it is not a promise of any particular result.
Common mistakes married couples make
Several well-intentioned moves can create eligibility problems, penalty periods, or unnecessary loss of income.
Spending down unnecessarily
Many couples begin private-paying and spending savings before getting advice — not realizing the spouse at home was entitled to keep far more.
Transferring assets without advice
Gifts or transfers to children can trigger the reinstated 30-month look-back penalty. Get advice first.
Accepting the standard income allowance
Couples often assume the $4,066.50 floor is all the spouse at home can keep, never learning a §3100 petition could protect much more.
Waiting too long
Some planning steps are most effective early. Delay can reduce the available options.
Changing title to the home
A rushed deed can cause reassessment, loss of the step-up in basis, and look-back problems.
Going it alone on the application
The married-couple rules are technical. A mistake on the application can cost real money.
Why timing matters
It is rarely too late to plan. Many of these steps — including a §3100 petition — can be pursued even after the institutionalized spouse is already in a nursing home, and even after Medi-Cal has been approved. That said, the snapshot date, the look-back rules, and the income calculations all have timing consequences. The sooner a married couple gets advice, the more options are typically available and the more income and savings can usually be protected.
If your spouse is already in a nursing home, see our guide to Crisis Medi-Cal Planning →
Questions married couples ask
These are general answers only. The right plan depends on your income, assets, and current California law.
How much of our savings can the spouse at home keep?
Under the 2026 Community Spouse Resource Allowance, the spouse at home may generally keep up to $162,660 in countable assets, in addition to exempt assets such as the family home, one vehicle, and personal belongings. The exact figure depends on the couple’s countable assets as of the snapshot date.
Can the spouse at home keep the nursing home spouse’s income?
In some cases, yes. If the community spouse’s own income falls below the Minimum Monthly Maintenance Needs Allowance of $4,066.50 in 2026, some of the institutionalized spouse’s income may be allocated to the community spouse. When that is still not enough, a Probate Code §3100 petition may allow the court to order a larger allocation — sometimes substantially larger.
Does the family home have to be sold?
Generally no, while the community spouse lives there. The home is typically an exempt asset during the lives of the spouses. You should obtain advice before transferring the home, however, because of estate recovery and look-back considerations.
What happens to our IRAs and retirement accounts?
Retirement accounts are treated differently depending on whose name they are in and whether they are in payout status. This is one of the most fact-specific areas of married-couple planning and should be reviewed carefully.
Is it too late if my spouse is already in the nursing home?
Often not. Many steps, including a §3100 petition, can be pursued after admission and even after Medi-Cal approval. The sooner you act, the more can usually be protected.
Talk with a California Medi-Cal planning attorney
If your spouse may need nursing home care, Staker Rodriguez Law LLP can help you protect your savings and your income before costly decisions are made. We have helped California families with Medi-Cal planning for over 35 years.
Disclaimer: This page is for general informational purposes only and does not provide legal advice. Viewing this page or contacting Staker Rodriguez Law LLP through it does not create an attorney-client relationship. Medi-Cal rules and dollar figures change and depend on the facts of each matter. Figures stated are 2026 California figures and are subject to change.
Last updated: June 2026.