---
type: Authority
title: 42 U.S.C. §1396r-5 (spousal impoverishment protections)
description: The federal statute that protects the at-home spouse when the other spouse enters long-term care, setting the community spouse resource and income allowances.
resource: https://www.law.cornell.edu/uscode/text/42/1396r-5
tags: [medicaid, spousal-impoverishment, community-spouse, csra, federal]
timestamp: 2026-06-22
jurisdiction: Federal
author: Patrick Nolan
authority_type: statute
citation: 42 U.S.C. §1396r-5
---

# Summary

42 U.S.C. §1396r-5 protects the spouse who stays at home (the community spouse) when the other spouse enters a nursing home and applies for Medicaid. It prevents the at-home spouse from being left impoverished by setting a protected share of the couple's assets and a minimum monthly income. Missouri applies these protections through MO HealthNet.

# Operative text

Paraphrased: when one spouse is institutionalized and applies for long-term-care Medicaid, the couple's countable resources are assessed as of the date care begins. The community spouse may keep a protected share, the Community Spouse Resource Allowance (CSRA), within federal floor and ceiling limits (the 2026 federal maximum is $162,660). The community spouse may also keep a minimum monthly income, the Minimum Monthly Maintenance Needs Allowance (MMMNA). Read the full section at the official source linked above.

# Decision rule

If one spouse needs nursing-home Medicaid and the other remains at home, the at-home spouse can keep a protected share of assets and income; calculate the CSRA and MMMNA before any spend-down rather than after.

# Related

- [MO HealthNet and Long-Term Care](/okf/elder-law-medicaid/medicaid-mo-healthnet.md)
- [42 U.S.C. §1396p (Medicaid liens, estate recovery, and transfer penalties)](/okf/authorities/federal/42-usc-1396p-medicaid.md)
- Official source: https://www.law.cornell.edu/uscode/text/42/1396r-5