SAGE || Advocacy and Services for LGBT Elders

A State Advocacy Guide for Understanding Spousal Impoverishment Protections, Medicaid and Same-Sex Couples

As the nation’s primary health insurance program for low-income individuals, Medicaid serves as the single largest payer of long-term care in the United States. Medicaid qualification rules include a series of “spousal impoverishment protections” that aim to prevent a healthy spouse from having to give up a family home or retirement savings, and live in poverty, in order to qualify his/her spouse for Medicaid. Unfortunately, these spousal impoverishment protections generally do not apply to same-sex couples. But now, states have federal guidance on how they can extend these protections to all couples. Visit sageusa.org/spousal impoverishment for more information.

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