Does DOMA being Struck-down Affect Medicaid for LGBT Elders?

Alina and Carol are married and reside in Maryland, where same-sex marriage is recognized. Alina recently had a stroke and may need nursing home in the not so distant future. How does the DOMA ruling affect Medicaid eligibility requirements for LGBT married couples and others in states that have not legalized LGBT marriage?

The answer is, it depends. Many states that have marriage equality did not treat same-sex married couples as married for many Medicaid programs, although several states have already been recognizing marriages between same-sex spouses for Medicaid purposes.

  • If your state recognizes LGBT marriage: Now that the federal Defense of Marriage Act (DOMA) has been ruled unconstitutional, every state that recognizes marriages between same-sex couples will recognize their marriages for all Medicaid purposes. So, Alina and Carol in our example would be affected.
  • If you are in a civil union or registered domestic partnership and your state recognizes your relationship: You may be treated as married for Medicaid purposes. We do not yet know if you will file federal taxes jointly with your partner. But if you do file taxes jointly, both of your incomes will be considered for most Medicaid income eligibility calculations, which could make you ineligible.  See CNN Money’s article on “Same-sex Marriage Ruling- Financial Impact” for more details.
  • If you live in a state that doesn’t recognize your relationship: You will probably not be recognized as married for Medicaid purposes, although some states may decide to provide hardship protections to a partner of a person in long term care.

For additional details, read the The Supreme Court Ruling on the Defense of Marriage Act: What It Means Fact Sheet.

Nursing homes in Northern Virginia cost $12,000 – $15,000 per month. Life Care Planning and Medicaid Asset Protection is the process of protecting you from having to go broke to pay for nursing home care, while also helping ensure that you get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. We here at The Fairfax LGBT Law Firm of Evan H. Farr, P.C. have strategies in place to help LGBT couples. With advance planning, each person, regardless of sexual orientation, can retain the benefit of the money, income and assets it has taken a lifetime to accumulate. Visit for more details, and call 703-691-1888 to make an appointment for a consultation.
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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.