Do You Lose Your Social Security if You Go Into a Nursing Home?

Social Security benefits continue to be paid when an individual enters a nursing home, but how they are applied can change significantly, often going towards the considerable cost of care. The way these funds are used depends on the individual’s financial situation and whether they are receiving assistance from programs like Medicaid.

Social Security Benefits and Nursing Home Costs

Social Security benefits are a primary source of income for many older adults and are paid directly to the recipient or their designated representative, even when they reside in a nursing home. These payments are applied toward the cost of nursing home care. For instance, the average monthly Social Security retirement payment in 2025 is approximately $1,979. However, the national median monthly cost for a semi-private room in a nursing home can be around $8,669, and a private room around $9,733.

Social Security benefits alone rarely cover the full expense of nursing home care. The average Social Security retirement benefit might cover about 23% of a semi-private room’s cost. Even with Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits, payments are directed to offset the cost of care. These benefits serve as a partial contribution to the overall charges.

Medicaid’s Role in Nursing Home Payments

Medicaid is a significant payer for nursing home care in the United States, often covering costs when individuals meet strict financial guidelines. Those who qualify for Medicaid must contribute their income, including Social Security benefits, towards their “patient liability” or “share of cost.” This is the amount of the individual’s monthly income paid to the nursing home before Medicaid covers the remaining balance.

Patient liability is calculated by subtracting allowable deductions from the resident’s total monthly income. Any remaining income is then considered the monthly patient liability, with Medicaid covering the rest of the nursing home costs. If a resident has no remaining income after deductions, there is no patient liability, and Medicaid covers the entire cost.

Patient liability amounts can fluctuate with changes in the resident’s income or allowable deductions. Individuals receiving Supplemental Security Income (SSI) may see their benefit payments reduced to approximately $30 per month if their nursing home stay is paid for by Medicaid.

Protecting a Spouse’s Income and Assets

Medicaid rules include provisions designed to prevent the “community spouse”—the spouse who remains living at home—from becoming impoverished when their partner enters a nursing home. These are known as “spousal impoverishment” rules. The Community Spouse Resource Allowance (CSRA) allows the community spouse to retain a portion of the couple’s combined assets.

For 2025, the federal minimum CSRA is $31,584, and the maximum is $157,920, though specific state limits may vary. Assets are considered jointly owned, regardless of whose name is on the account. The CSRA aims to ensure the community spouse has sufficient resources for their living expenses.

Another safeguard is the Minimum Monthly Maintenance Needs Allowance (MMMNA). This allowance permits a portion of the institutionalized spouse’s income, including their Social Security benefits, to be allocated to the community spouse if their own income falls below a certain threshold. For 2025, the federal minimum MMMNA is $2,643.75 per month, with a maximum of $3,948 per month in most continental U.S. states. This allocation helps ensure the community spouse has a minimum income to live on, potentially reducing the amount the institutionalized spouse contributes to their nursing home care.

Managing Social Security Funds While in a Nursing Home

The management of Social Security funds for a nursing home resident involves specific allowances and, in some cases, the appointment of a representative. A “Personal Needs Allowance” (PNA) is a small portion of a resident’s income, often including Social Security, that they are permitted to keep for personal expenses. This allowance is intended for items like clothing, toiletries, or other small personal purchases.

The PNA amount varies by state, ranging from $30 to $200 per month. While federal law mandates a minimum PNA of $30, states have the option to allow a higher amount. Any unspent PNA funds can accumulate, but residents must be mindful of Medicaid’s asset limits, which are $2,000 for an individual.

If a nursing home resident is unable to manage their own financial affairs, the Social Security Administration (SSA) may appoint a “representative payee.” This individual or organization receives the Social Security benefits on behalf of the resident. The representative payee’s primary responsibility is to use the funds to meet the beneficiary’s current and future needs, such as housing, food, and medical costs. They are also required to keep detailed records of how the funds are spent and report changes in the beneficiary’s circumstances to the SSA.