Community Spouse Resource Allowance in New York (2026)

The Healthy Spouse Doesn't Have to Go Broke

When one spouse needs Medicaid-funded long-term care in New York — whether in a nursing home or through a home care program — the other spouse isn't required to drain every dollar of their savings to pay for it. Federal and state spousal impoverishment protections guarantee that the "community spouse" (the one who doesn't need care) can keep a substantial portion of the couple's assets and income.

These protections exist because the alternative was unconscionable: before Congress enacted the Medicare Catastrophic Coverage Act of 1988, the healthy spouse of a Medicaid applicant often had to impoverish themselves to qualify the sick spouse for coverage. The community spouse resource allowance (CSRA) and related protections fix that — but the rules are specific, and failing to understand them can cost a family tens of thousands of dollars in unnecessary spend-down.

2026 Community Spouse Resource Allowance

The CSRA is the maximum amount of countable assets the community spouse can retain without affecting the applicant spouse's Medicaid eligibility. For 2026 in New York:

• Maximum CSRA: $162,660
• Minimum CSRA: $74,820

How these limits work: when the applicant spouse applies for Medicaid, the local Department of Social Services takes a "snapshot" of the couple's total combined countable assets as of the first day of the month the institutionalized spouse entered a care facility (the "snapshot date"). The community spouse then keeps either half of the total combined assets or the minimum CSRA — whichever is greater — up to the maximum.

Example 1: Combined assets of $250,000. Half is $125,000. The community spouse keeps $125,000, and the applicant spouse must spend down their share to $33,038 (the individual asset limit).

Example 2: Combined assets of $400,000. Half is $200,000, but the CSRA caps at $162,660. The community spouse keeps $162,660, and the excess must be spent down.

Example 3: Combined assets of $50,000. Half is $25,000, but the minimum state CSRA is $74,820. Because the couple has less than that amount, the community spouse may retain the couple's full $50,000 in countable assets under the minimum CSRA calculation; other eligibility rules still apply.

Minimum Monthly Maintenance Needs Allowance

Beyond assets, the community spouse is entitled to a minimum monthly income. The Minimum Monthly Maintenance Needs Allowance (MMMNA) for 2026 is up to $4,066.50. If the community spouse's own income falls below this amount, they can receive an income allocation from the institutionalized spouse's income to bring them up to the MMMNA.

This prevents a common nightmare scenario: a spouse whose household income came primarily from the now-institutionalized partner being left without enough money to cover their own housing, food, and living expenses.

If the community spouse's shelter costs (rent or mortgage, property taxes, utilities, insurance) exceed a certain threshold, they may qualify for an excess shelter allowance that increases the MMMNA further. The calculation is specific to the community spouse's actual housing costs.

What Counts as "Countable" Assets

Not everything a couple owns is counted toward the CSRA calculation:

Exempt assets (not counted):

• The family home — up to $1,130,000 in equity for 2026, provided the community spouse or a dependent resides there
• One vehicle
• Personal belongings and household furnishings
• Prepaid, irrevocable burial arrangements and a burial fund (typically up to $1,500 per person)
• Term life insurance
• Whole life insurance with a combined face value under $1,500

Countable assets (included in the CSRA calculation):

• Bank accounts (checking, savings, money market)
• Certificates of deposit
• Stocks, bonds, mutual funds
• IRAs and 401(k) accounts (in most cases — New York treats retirement accounts as countable for the account holder, though strategies exist)
• Investment real property (rental properties, vacant land)
• Cash value of whole life insurance over $1,500 face value

The community spouse's own retirement accounts are counted in the snapshot but are protected up to the CSRA. This distinction matters: a community spouse with $150,000 in an IRA doesn't need to liquidate it, as long as it falls within their CSRA allowance.

Spousal Refusal: When the CSRA Isn't Enough

If the community spouse's assets substantially exceed the $162,660 CSRA — say, $500,000 in combined savings — the standard spend-down could be devastating. New York provides an alternative through "Spousal Refusal" under Social Services Law § 366(3)(a).

The community spouse files a written declaration with the Department of Social Services stating that they refuse to make their income and resources available for the applicant spouse's care. Medicaid must then evaluate the applicant based only on their individual assets and income.

Spousal refusal is legal and well-established in New York law, but it's not risk-free. The Department of Social Services retains the right to sue the refusing spouse to recover the cost of Medicaid services. Whether they actually pursue recovery varies by county — some pursue it aggressively, others rarely or never. Any court-ordered recovery is calculated at the state's discounted Medicaid reimbursement rate, not the private-pay nursing home rate.

Families considering spousal refusal should coordinate with the community spouse's own estate plan. Because spousal refusal exposes the refusing spouse to a possible recovery action, the effect of the spouse's death and estate plan on any claim is fact-specific. If the refusing spouse is the survivor, any recovery judgment during their lifetime could affect their available assets.

Protecting the Community Spouse's Quality of Life

The CSRA and MMMNA set the floor, not the ceiling, for what the community spouse can retain. Additional protections and strategies include:

• Fair hearing rights: If the CSRA doesn't leave the community spouse with enough to maintain their standard of living, they can request a Medicaid fair hearing to increase their allowance based on demonstrated need.
• Court-ordered support: A family court can order additional support for the community spouse beyond the standard CSRA, based on their individual circumstances.
• Income-first rule: New York follows the "income-first" approach — if the community spouse's income is below the MMMNA, Medicaid first looks to income allocation from the institutionalized spouse before increasing the CSRA.

The New York Power of Attorney & Guardianship Kit walks through the spousal impoverishment protections in detail, including CSRA calculation worksheets, spousal refusal procedures, and the POA modifications needed to execute Medicaid applications and asset protection strategies on behalf of a cognitively impaired spouse.

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