Same Sex Marriage as Married for Medicaid?

Yes, same sex marriages are legally recognized and receive the same rights as heterosexual marriages when it comes to Medicaid eligibility. This means that your same sex spouse will be able to remain living in the primary home (principle married homestead) if you relocate to a Medicaid-funded nursing home, assisted living residence, or another type of residential facility.

Prior to June 26, 2015, 13 states did not allow same sex marriage. However, with the ruling of Obergefell v. Hodges on June 26, 2015, same sex marriage became legal across the United States. As a result, all federal agencies are required to extend the same rights to same sex married couples as heterosexual married couples. This includes Medicaid’s federal Spousal Impoverishment Protections, which are set forth to prevent non-applicant spouses of long-term care Medicaid spouses from going broke in order for their spouses to meet Medicaid’s income and asset limits. Spousal Impoverishment Rules are for married couples (including same sex couples) in which one spouse is applying for Nursing Home Medicaid or home and community based services (HCBS) via a Medicaid Waiver.

Same sex marriages are also extended protection from Medicaid’s Estate Recovery Program. Following the death of a Medicaid recipient, via estate recovery, Medicaid attempts to collect reimbursement for the cost of long-term for which it paid for the deceased. In most cases, the largest valued asset that remains is one’s home. However, Medicaid is not able to take the home as long as there is a surviving spouse (same sex or opposite sex).