Medi-Cal Spousal Protection in California: What the Spouse at Home May Keep

Medi-Cal is for people with limited income and assets. Without a special rule, a couple would have to use up nearly everything they own before Medi-Cal paid for one spouse's long-term care, and the other spouse would be left with very little.

The spousal impoverishment rules prevent that. California Advocates for Nursing Home Reform (CANHR), a nonprofit that publishes consumer fact sheets, explains that they let the spouse who is not using Medi-Cal keep additional income and assets. The rules also cover registered domestic partners.

Two terms come up in every notice. The spouse who needs care is called the institutionalized spouse, even when he or she is getting services at home. The other is the community spouse. Medi-Cal treats them as two separate households, not one household of two.

The Department of Health Care Services (DHCS), which runs Medi-Cal, published the 2026 figures in a letter to counties dated January 28, 2026. They took effect January 1, 2026 and change each year, so confirm them with the county Medi-Cal office before you rely on them. The 2026 figures are:

Only countable assets are measured against these numbers. CANHR's 2026 fact sheets say the home, one car, household goods and personal effects are not counted. Retirement accounts and work pensions in the community spouse's name are not counted either. Our guide to Medi-Cal asset and income rules covers what counts for everyone.

A couple does not have to sort out every account before applying. The DHCS letter describes a transfer period. It begins with the first month of eligibility and ends on the last day of the month in which the 90th day falls after the approval notice is mailed. During that time the spouse on Medi-Cal can move countable property out of his or her name to the community spouse. Property above $130,000 still in that spouse's name at the end is treated as excess, unless undue hardship applies.

The resource allowance is a test at the start. DHCS says it applies to the first month of eligibility only, and after that the community spouse's own property is no longer considered. CANHR gives the example of an inheritance received by the community spouse after approval, which does not affect the other spouse's Medi-Cal.

One date to watch: DHCS's public asset limit page says the general limit falls from $130,000 to $21,000 for one person on July 1, 2027, and that some married couples may qualify for higher limits. As of October 2026 we could not find state guidance on how that change will apply to couples under these rules. Ask the county.

Income follows the name on the check. CANHR explains that the community spouse keeps all income received in his or her own name, in any amount, and it is not counted toward the other spouse's eligibility or share of cost.

If the community spouse's income is below $4,067 a month in 2026, the spouse on Medi-Cal may allocate income to bring it up to that level. DHCS instructs counties to subtract Medicare and other health insurance premiums from the community spouse's income before making the comparison. The allocation lowers the Medi-Cal spouse's countable income, which can reduce or remove a share of cost. See Medi-Cal share of cost explained.

If the community spouse's income is above that level, there is no allocation, but he or she still keeps all of it. CANHR adds that a couple can ask for a fair hearing to raise the income allowance, and that the spouse on Medi-Cal decides how much to allocate when a full allocation would not help.

The DHCS letter says the income allowance applies when the institutionalized spouse:

• Lives in a skilled nursing facility.
• Is on the waitlist for a Medi-Cal home and community-based services (HCBS) program.
• Is actively taking part in an HCBS program.

CANHR's fact sheets name several programs that count. In-Home Supportive Services counts when the person is in its Community First Choice Option, which the county can confirm. CANHR's fact sheet on the Program of All-Inclusive Care for the Elderly says the spousal provisions apply there too. Our guides to IHSS and assisted living and PACE programs in California explain each.

Assisted living needs care here. Living in an assisted living community or a board and care home, licensed in California as a residential care facility for the elderly (RCFE), and paying privately does not make a person an institutionalized spouse. The rules come into play when that person applies for a qualifying Medi-Cal program. CANHR lists the Assisted Living Waiver among Medi-Cal's home and community-based waiver programs, so ask the county how the rules would apply to a waiver applicant.

To ask for the protection, CANHR says to apply for Medi-Cal, state on the application that the person needs help with daily activities, and show a need for a nursing facility level of care. That is done with a doctor's verification form from the county or through an HCBS program's own assessment. A county decision can be appealed at a fair hearing.

Hamssa Benrekia is a senior living placement specialist in Torrance who works with families in the South Bay and Harbor area of Los Angeles County. She does not decide Medi-Cal eligibility or give legal or financial advice: an elder law attorney, a legal aid program for older adults or the county does that. She can talk through what each spouse needs and which local homes may fit the budget, including a board and care home. Our guide to couples paying for assisted living covers the wider picture. To talk it through, contact Hamssa. The full series is in the California Assisted Living Placement Guide.