Honolulu Senior AdvisorHow much can a spouse at home keep when the other spouse goes on Med-QUEST?
Under federal spousal impoverishment rules, the spouse who stays at home keeps a share of the couple's countable assets called the community spouse resource allowance, which for 2026 is at least $32,532 and at most $162,660, plus the home within federal equity limits.
| 2026 federal spousal standard | Amount |
|---|---|
| Community spouse resource standard, minimum | $32,532 |
| Community spouse resource standard, maximum | $162,660 |
| Maximum monthly maintenance needs allowance | $4,066.50 |
Source: CMS Informational Bulletin, Updated 2026 SSI and Spousal Impoverishment Standards (April 27, 2026).
The spouse at home can also receive part of the applicant's monthly income as a maintenance allowance, up to a federal maximum of $4,066.50 a month in 2026, if their own income is low. Hawaii applies these federal standards through Med-QUEST; ask for the calculation in writing.
What is the look-back period?
The look-back is the 60 months before a long-term care Medicaid application, during which Med-QUEST reviews gifts and sales below fair market value; transfers in that window can trigger a penalty period during which Medicaid will not pay for long-term care.
Transfers between spouses are generally allowed, and some transfers are exempt, such as to a disabled child. Paying a family member for care without a written agreement can look like a gift. The safest course is to keep records of every large transaction and talk to an elder law attorney before moving money.
Will Med-QUEST take the house?
Med-QUEST does not take a home while a spouse or certain relatives live there, but federal law requires states to seek estate recovery for long-term care costs from the estates of members 55 and older after death, subject to exceptions such as a surviving spouse or disabled child.
Families sometimes delay applying because of the house. A short consultation with an elder law attorney usually shows that the right plan protects more than the family expected.
What should we gather before applying?
Gather five years of bank and investment statements, deeds, insurance policies, income records for both spouses, and records of any large gifts or transfers before applying for Med-QUEST long-term care.
- Social Security and pension award letters
- Long-term care insurance policy and claims history
- Burial or pre-need contracts
- Vehicle titles
- Powers of attorney and advance directives
At a glance
| The rules protect | The rules don't protect | |
|---|---|---|
| Assets | The community spouse's allowance (up to $162,660 in 2026) | Unlimited savings |
| Home | The home while a spouse lives there | The home from estate recovery in every case |
| Income | A maintenance allowance for a low-income spouse | The applicant's full income |
| Transfers | Transfers between spouses | Gifts to children inside 60 months |
Sources include Hawaii Administrative Rules chapters 11-100.1, 11-90 and 11-800, HRS 321-481 and 321-1.8, Office of Health Care Assurance rosters and pages, the 2026 HHS poverty guidelines, CMS, CareScout and VA rate tables as cited above; see our editorial standards.
