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My spouse needs more care than I can give

Options that keep a couple together, and the spousal protections Medicaid provides.

Quick answer

Options that keep a couple together, and the spousal protections Medicaid provides.

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Home›By Situation›My spouse needs more care than I can give

Caring for a spouse is different from caring for a parent, financially and otherwise. New York's spousal impoverishment protections -- the Community Spouse Resource Allowance and Minimum Monthly Maintenance Needs Allowance -- exist specifically for this situation.

Short answer

Options that keep a couple together, and the spousal protections Medicaid provides.

What to do, in order

  1. Understand the spousal protections. New York's 2026 Community Spouse Resource Allowance ($74,820-$162,660) and Minimum Monthly Maintenance Needs Allowance ($4,066.50/month) protect a healthy spouse's finances when the other spouse needs Medicaid-funded care.
  2. Look at communities that keep couples together. Several campuses offer more than one level of care on one site.
  3. Be honest about your own health. Spousal caregivers routinely under-report their own decline.
  4. Get an objective assessment. The Area Agency on Aging serving your county can assess both of you at no cost.

Questions families ask

How much spending money is a Medicaid nursing home resident allowed to keep each month in New York?

New York's Nursing Home Resident Personal Needs Allowance is $50 per month - the amount a Medicaid-funded nursing home resident is permitted to keep from their own income for personal expenses, with the rest going toward the cost of their care. According to the NY State Office for the Aging (NYSOFA), this figure has been unchanged since the 1980s, and NYSOFA notes that 33 other states currently pay a higher PNA, ranging from $52 to $200.

What is the MLTC special income standard for Long Island and why does it matter for Medicaid home care?

The special income standard for housing expenses, available to certain individuals enrolled in a Managed Long Term Care plan, varies by NYSDOH region - for the Long Island region specifically, it is $1,701.00. This regional figure is higher than most upstate regions (for comparison, the Central New York region's is $426 and the Western region's is $341), reflecting Long Island's higher housing costs, and remains in effect until updated federal poverty levels are published.

How much does assisted living cost in New York State?

According to CareScout's 2025 Cost of Care Survey, the median cost of an assisted living community (private one-bedroom) in New York State is $225 per day, or about $7,110 per month and $85,320 per year. This is a statewide median - CareScout's published state-level data tables do not break out a separate Long Island or metro New York figure.

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