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My spouse needs more care than I can give

Options that keep a couple together, and the spousal protections Medicaid provides.

Quick answer

Options that keep a couple together, and the spousal protections Medicaid provides.

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Caring for a spouse is different from caring for a parent, financially and otherwise. Minnesota spousal Medicaid protections can shield a meaningful amount of the couple's assets and income for the spouse who stays home.

Short answer

Options that keep a couple together, and the spousal protections Medicaid provides.

What to do, in order

  1. Understand the spousal protections. The 2026 Community Spouse Asset Allowance for Minnesota ranges from $32,532 to $162,660, and the Minimum Monthly Maintenance Needs Allowance ranges from $2,705 to $4,066.50 a month -- confirm current figures with DHS before relying on them.
  2. Look at communities that keep couples together. Several campuses offer more than one level of care on one site.
  3. Be honest about your own health. Spousal caregivers routinely under-report their own decline.
  4. Get an objective assessment. The Area Agency on Aging serving your county can assess both of you at no cost.

Questions families ask

Independent living vs. assisted living vs. memory care — how do I know which one my parent needs?

Independent living is unlicensed housing with no care services; assisted living is a licensed setting (Chapter 144G) providing help with daily activities and some health services; memory care is the separately licensed 'assisted living facility with dementia care' category for residents needing secured, dementia-specific care. The right fit depends on a functional assessment of daily living needs, cognitive status, and safety risk, not just preference.

Assisted living vs. in-home care — which is better for a parent who wants to stay independent?

In-home care lets a parent remain in their own home with support delivered through the Elderly Waiver (personal care, homemaker, home health aide) or private-pay caregivers, while assisted living moves a parent into a licensed community with built-in staffing, meals, and social programming. The better fit depends on the level and predictability of care needed, home safety, and cost once care hours increase significantly.

What license does an assisted living facility need in Minnesota?

Every assisted living community in the Twin Cities must hold an Assisted Living Facility license issued by the Minnesota Department of Health (MDH) under Minnesota Statutes, Chapter 144G. This has been mandatory statewide since August 1, 2021, replacing the older, looser 'Housing with Services' registration model. Facilities must also employ an assisted living director credentialed by the Board of Executives for Long Term Services and Supports.

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