Unfortunately, we face an increasing risk of spending some part of our lives living in a nursing home. Most of us now know how expensive nursing homes are, $100,000 a year or more, and we know that few people have the resources to pay this for long. Absent planning, what typically happens is that the person who moves into a nursing home quickly spends down all his or her assets, and then, once impoverished, is put on the Medicaid program. 

One may ask, Do nursing homes take your social security check and or pension when you go into a nursing home? 

The government and nursing homes are not allowed to directly seize assets. What most of us don’t know is what happens to one’s monthly Social Security and pension checks once the person uses up all of his or her assets. The basic rule is that all your monthly income goes to the nursing home, and Medicaid then pays the nursing home the difference between your monthly income, and the amount that the nursing home is allowed under its Medicaid contract. The only exception that always applies is that Medicaid will allow you to keep a certain amount of money each month to pay for your “Personal Needs,” such as the beauty shop, or postage stamps, or for the phone in your room. The amount varies by state. For example, In Michigan the Medicaid Monthly Personal Needs Allowance is $60. This is the amount of income they are allowed to keep each month for personal expenses.

Medicaid also allows a few other exceptions. You may be able to show that your income is needed by your spouse or a dependent child. You may need your income to pay off old medical bills. Or, if you will only be in the nursing home for a short period of time, you may need your income to pay the costs of keeping up your home or apartment while you are gone.

For example, if you are married and your spouse isn’t living in a nursing home, then part of your income can go to your spouse, provided he or she has limited income. Under Medicaid’s spousal impoverishment rules, the healthy spouse can keep a certain amount of income each month to avoid impoverishment. In 2026, federal guidelines set a Minimum Monthly Maintenance Needs Allowance (MMMNA) of approximately $2,644 per month, meaning income can be transferred to a community spouse up to that level if needed. The MMMNA can be higher if the spouse has significant housing or utility expenses, though any income allotted to the spouse cannot exceed the Maximum Monthly Maintenance Needs Allowance of approximately $4,066 per month.

Because these figures are adjusted annually for inflation and cost-of-living changes, the specific amounts may increase in future years, and it’s important to verify current limits when planning.

Some of your monthly income can also be set aside if you have a minor child or a dependent adult child.

If you have existing unpaid medical bills, and go into a nursing home and receive Medicaid, the program may allow you to use some or all of your current monthly income to pay the old bills, rather than just to be paid over to the nursing home, providing you still owe these old medical bills and you meet a few other requirements.

Minimum & Maximum Maintenance Needs Allowances change each year based on federal guidance, and states like Michigan apply these federal figures directly to protect spouses from losing all their income when one spouse enters a nursing home