Married but Separated: Does a Spouse's Money Count for Florida Medicaid?

Theresa's Situation: A Decade Apart, Still Married

Theresa is 71 and lives in Deltona. She and her husband separated ten years ago. They never filed for divorce, never divided their retirement accounts, and have not spoken about money in years. Theresa built her own modest savings after the separation. Now she needs nursing home care, and she has learned that Florida Medicaid wants information about a husband she has not lived with in a decade. Theresa is a composite example I use to illustrate a situation I see often in my practice, not an actual client, but her circumstances reflect a genuine and common problem for Florida families.

Her question is the one I hear from adult children constantly: does an estranged spouse's money really count, even after this much time apart?

Why Marriage, Not Living Arrangements, Controls

Florida law does not have a category called legal separation. A couple is either married or divorced. There is no in-between status that changes how Medicaid treats a couple's finances. This surprises a lot of families, because in everyday life a ten-year separation feels final. Legally, though, it changes nothing about how the Department of Children and Families (DCF) evaluates an application.

Because Theresa and her husband are still legally married, Florida applies what is known as the spousal impoverishment framework to her case. Under this framework, when one spouse (the institutionalized spouse) applies for nursing home Medicaid, the countable assets of both spouses are generally treated as belonging to the couple as a unit, regardless of whose name is on the account, how long they have lived apart, or whether they file separate tax returns. Living apart, keeping separate bank accounts, and even having no contact at all does not convert a married couple into two single individuals for Medicaid purposes.

This rule exists because Congress designed the Medicaid spousal impoverishment rules to prevent a couple from artificially separating assets on paper while remaining married in fact. Florida follows the federal framework found in federal Medicaid law, along with the state's own implementing rules through DCF.

What the State Wants to Know About the Absent Spouse

When Theresa applies, DCF will ask for financial information about her husband even though he is not the one seeking care. This typically includes bank and investment account statements, retirement account balances, real estate holdings, vehicle titles, and any other countable resources in his name. The state combines the countable assets of both spouses as of a specific snapshot date to determine the couple's total resources, then applies the spousal rules to figure out how much the community spouse, the one staying home, is allowed to keep.

The healthy spouse who remains in the community is entitled to keep a specific dollar amount of the couple's combined countable assets. This is called the Community Spouse Resource Allowance, or CSRA. Florida is what's known as a "100% state," meaning the community spouse may keep up to the full allowed amount regardless of whose name the assets are actually in. The exact dollar figure adjusts periodically, so I always tell families to confirm the current number with DCF or with an elder law attorney rather than relying on a figure from a prior year.

For Theresa, the practical problem isn't the rule itself. It's that her husband will not provide any financial information at all, and he has made clear he has no interest in helping with her application.

Theresa's Three Realistic Paths Forward

When a spouse refuses to cooperate, families in Theresa's position generally have three options. Each has real tradeoffs.

• Cooperation. If the absent spouse can be persuaded to provide documentation, even without providing money, this is often the simplest path. It allows the caseworker to calculate the CSRA and finalize the application without further legal maneuvering. For some couples, a candid conversation about the fact that the state is not asking him to pay anything, only to disclose information, is enough to resolve the standoff.
• Spousal refusal. Federal Medicaid law requires that a state allow the institutionalized spouse to apply even when the community spouse formally refuses, in writing, to make his assets available for her care. This is sometimes called a "spousal refusal" or "just say no" strategy. It typically involves the community spouse signing a formal notice of refusal, after which the state must evaluate Theresa's application based on her own resources. Florida retains the legal right to later pursue the refusing spouse for reimbursement of Medicaid costs paid on her behalf, though enforcement of that right is not something I can promise will or will not happen in any given case. This route requires careful legal drafting and is not a do-it-yourself project.
• Divorce. After ten years of separation, some spouses do eventually choose to formalize the split through divorce, which severs the spousal asset-counting rules going forward. This is a significant, permanent legal step that involves Florida family law, not just Medicaid rules, and it is not something I recommend as a casual planning tool. If assets are moved around specifically to qualify for Medicaid as part of a divorce, DCF can scrutinize those transfers under the standard five-year lookback period, so timing and documentation matter enormously.

Weighing the Options for Someone Like Theresa

For Theresa, divorce after this many years apart might eventually make sense as a life decision, but it is a slower, more expensive, and more emotionally complicated route than spousal refusal, and it carries its own scrutiny if done with Medicaid timing in mind. Cooperation would be the cleanest outcome, if her husband can be persuaded to simply disclose information rather than hand over money. Spousal refusal exists as a federally protected option precisely because Congress recognized that some spouses will not cooperate, and it lets Theresa's application move forward without waiting on a divorce or a reluctant husband.

Every one of these paths has consequences that ripple beyond the Medicaid application itself, touching estate planning, potential support obligations, and family relationships. This is exactly the kind of decision where a family in Theresa's position benefits from sitting down with an elder law attorney who can walk through the couple's specific numbers and circumstances before choosing a direction.

Sources

• Zoecklein Law, P.A., "Florida Medicaid Spousal Impoverishment: Community Spouse Rules (2026)", July 26, 2026
• B&B Elder Law, "How Much Money Can a Spouse Keep When the Other Goes on Medicaid?", March 31, 2026
• Scott Law Offices Florida Medicaid and Elder Law, "What Happens to Your Spouse's Medicaid Benefits After a Divorce or Separation in Florida?", May 20, 2026
• Elder Needs Law, "Spousal Refusal and Florida Medicaid Planning", May 15, 2026
• Medicaid Planning Assistance.org, "Florida Medicaid Eligibility: 2026 Income & Assets Limits", 2026

This article is for general informational purposes only and does not constitute legal advice, nor does reading it create an attorney-client relationship. Florida estate, elder, probate, and real estate law are fact-specific and change over time. Consult a licensed Florida attorney about your individual circumstances. Arthur Simpson, Esq. is licensed to practice law in the State of Florida. Attorney advertising.