A well spouse can only keep certain assets if their ill spouse needs Medicaid.

    Currently (as of May, 2023), the maximum amount of so-called available assets that the well spouse can keep is $148,620 (although sometimes the amount that can be kept is even less than this).  This can be kept in the form of cash, extra car(s), whole life insurance policies, retirement accounts, or any other non-exempt asset(s), or any combination thereof.

    The well spouse can also keep certain assets in addition to the up to $148,620 in general assets that are exempt from calculation, and exempt from spend down.  These include annuitized annuities (in some circumstances), a home (in some circumstances), irrevocable prepaid burial and funeral plans, one car, and (generally speaking) not much else.

    Nonetheless, a good elder law lawyer can help a person to understand what assets are considered available and what assets are exempt from spend down, what assets may be purchased, how certain assets can be turned into streams of income that can be kept, What assets may be best to keep, and the like.  

    A good elder law lawyer can also help a person to avoid pitfalls like buying things that are NOT considered exempt assets, making transfers or even purchases that create periods of Medicaid ineligibility,  how to avoid buying things that result in the State assessing the purchase to be a transfer that creates a period of Medicaid ineligibility, and how to avoid purchasing things that may have to be re-sold at a loss almost immediately in order to qualify for Medicaid.

    The difference between what can be kept and/or converted into streams of income that can be kept, versus what someone might spend down to without good advice, can be many hundreds of thousands of dollars in some cases.