Illinois Spousal Income Allowance

2026 Illinois figures · reviewed September 4, 2026

Shows how a couple's monthly income is divided once one spouse is on Illinois Medicaid in a nursing home, and what the spouse at home keeps. About

In plain words. When one spouse is in a nursing home on Medicaid, their income goes to the nursing home as their share of the cost, except for a small personal allowance. But Illinois first makes sure the spouse still at home has enough to live on: if that spouse's own income is below a set monthly allowance, the difference is moved over from the spouse in care before the nursing home is paid. This tool takes both incomes and shows the split.

Why it matters. The fear of the spouse at home is being left with nothing. The allowance is the answer to that fear, and knowing the number changes how a couple plans the move into care.

An example. The spouse at home has $1,500 a month of their own; the spouse in care has $4,000. About $2,567 shifts to the spouse at home, bringing them to about $4,067 a month; the spouse in care keeps $60; the nursing home receives about $1,373 and Medicaid pays the rest.

Where it stops. It covers income, not assets, which the runway and penalty tools handle. It does not model a shortfall claim for more assets at a hearing, court-ordered support, or the rules for home care instead of a nursing home. Everything it leaves out.

Monthly income of the spouse at home, in their own name

Their own Social Security, pension, and other income. Medicaid never takes this income.

Monthly income of the spouse in the nursing home

Their own Social Security, pension, and required retirement account withdrawals.

What the spouse at home keeps each month

$4,066.50

That is their own $1,500 plus $2,566.50 shifted over from the spouse in care. The shift is allowed because the law lets the spouse at home keep a monthly allowance of $4,066.50. The spouse in care keeps $60 for personal needs. The rest, $1,373.50, goes to the facility as the patient's share, and Medicaid pays the balance.

Monthly allowance for the spouse at home: $4,066.50; Illinois uses the highest amount federal law allows
Income shifted from the spouse in care: $2,566.50; Enough to reach the allowance
Patient's share paid to the facility: $1,373.50; What the spouse in care pays the nursing home each month before Medicaid pays the rest

The spouse at home's own income is never touched. If it is under the allowance, the difference comes out of the spouse in care's income first, before the facility is paid. If that income cannot fill the gap, the shortfall can be the basis for asking a hearing to let the couple keep more assets, which is work for an elder-law attorney.

This uses the 2026 Illinois nursing-home Medicaid figures, a monthly allowance for the spouse at home of $4,066.50 and a personal needs allowance of $60. It looks at income only. It leaves out a claim to keep more assets because of a shortfall, court-ordered support, allowances for other dependents, and deductions for health insurance premiums. Educational, not advice.

This is a simplified model, not your actual tax return or plan. It only knows what you type in, leaves out rules that may apply to you, and cannot weigh the other facts and trade-offs a real decision depends on. Before you act, talk with a professional who knows your whole situation.

Educational only, not investment, tax, or legal advice. Results are hypothetical estimates that vary with each use and over time and are not guaranteed accurate or complete. Using this tool creates no client relationship with Considerate Capital, and the site that linked here is not affiliated with it. By using it you agree to the tool terms.