Protecting a spouse when one partner needs long-term care

What happens to the at-home spouse when a partner enters a Knoxville nursing home on TennCare?

Federal spousal impoverishment rules let the spouse who stays at home keep a share of the couple's countable assets, the community spouse resource allowance, and a minimum monthly income, the maintenance needs allowance, while the other spouse qualifies for TennCare long-term care.

These protections apply whether the partner needing care goes to a nursing home through CHOICES Group 1 or receives home and community services through Groups 2 or 3. The rules are federal standards that TennCare applies.

How much can a community spouse keep in 2026?

For 2026 the community spouse resource standard ranges from a minimum of $32,532 to a maximum of $162,660, and the minimum monthly maintenance needs allowance is $2,705.00 (effective July 1, 2026) up to a maximum of $4,066.50.

Source: CMS Informational Bulletin, Updated 2026 SSI and Spousal Impoverishment Standards (April 27, 2026).

How the resource allowance is figured within that range depends on the state's method and the couple's assets on the date care began, which is one reason couples should talk to an elder law attorney before applying.

Does the home count against TennCare eligibility?

The home where you or your spouse lives is generally excluded from the resource count, but federal rules cap home equity for long-term care Medicaid; for 2026 the limits run from $752,000 to $1,130,000 depending on the state's election, and the cap does not apply while a spouse lives in the home.

Estate recovery is a separate issue: after the TennCare recipient dies, the state can seek repayment from the estate for long-term care costs, with protections when a spouse survives. Ask about it before you decide how to hold title to the house.

What mistakes do Knoxville couples make with spending down?

The most common are giving money to children inside the five-year look-back, paying relatives for care without a written agreement at fair rates, and spending the at-home spouse's protected share on the nursing home bill before applying.

Legitimate spend-down includes paying off a mortgage, home repairs, a new car for the community spouse, prepaid funeral arrangements and medical equipment. A Qualifying Income Trust handles the opposite problem, income above the $2,982 cap. An elder law attorney can map which steps fit your situation.

Where can a Knoxville couple get help with the TennCare spousal rules?

Start with the ETHRA Area Agency on Aging and Disability at 1-866-836-6678, which screens for TennCare CHOICES and runs legal services for older adults, then consult an elder law attorney licensed in Tennessee for planning.

Bring five years of bank statements, deeds, insurance policies and income letters to the first meeting. The TennCare LTSS help desk, 1-877-224-0219, can answer process questions but not give planning advice.