The Listen to Lawrence Letter: A spousal income question answered

January 5, 2024
January 4, 2023 • Volume 5 Issue 205
A spousal income question…read on:


Lawrence, my question today is: If my spouse needs to go into a nursing home, does Medicaid allow me, the at-home spouse to keep any money from my RMDs and my Social Security?

I always look forward to reading your letters. Wishing you a happy holiday and a healthy new year.


Thank you for your kind words and wishes! I wish the same to your family and all my readers.

The simple answer is if one spouse is on Medicaid in a nursing home, the income of the at-home spouse is not counted for Medicaid eligibility purposes with a spousal refusal letter. Period. However, after eligibility, Medicaid still has the right to ask the at-home spouse to contribute to their spouse’s care, and Medicaid has a right to sue for such contribution. “In sickness and in health,” remember? The good news is that we have never seen Suffolk County Medicaid bring these actions and it has been many years since we have experienced this in Nassau County. Years ago Medicaid asked for 25% of the spouse’s excess income to buy off the issue entirely. They asked (intimidation) but we never gave…and that was the end of it. While this can all change, I would sleep well at night.

As I said, this is the simple answer. Everyone’s situation is different and should be carefully reviewed before applying for Medicaid. When considering Medicaid and before applying, please understand how important it is for you to receive the right advice. Come in to see us first!

I hope this helps!

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As always, please send me your questions. If you are thinking about it, others are probably too, so my answers will no doubt help you and many others.


Let’s stay connected.

Stay safe!