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In most states, the assets and income of both spouses are considered when determining whether either is eligible for Medicaid benefits.

New York follows the “spousal refusal” doctrine.  Spousal refusal means that a legally responsible spouse refuses to make his or her assets available to pay for the care of the other spouse.  Bear in mind that the ill spouse may have transferred all of his or her assets to the well spouse, in order to become eligible for Medicaid.

In the face of a “spousal refusal,” Medicaid is required to provide care to the spouse who needs care.

However, Medicaid retains the right to make a claim for reimbursement from the refusing spouse or their estate.  If such a claim is made, the refusing spouse is still likely to pay much less for the care of the ill spouse than if the couple had paid regular private pay rates for the care.

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