If Your Spouse Needs Memory Care in Kansas, You Could Lose Everything — Unless You Do This

The phone call comes, or maybe it's a slow, painful realization over months. Your spouse has dementia. They need more care than you can provide at home. And memory care facilities cost $9,000 to $12,000 a month.

Your first instinct is to pay it. Of course you pay it. This is your spouse.

But nobody tells you what happens six months from now, or a year from now, when the savings account starts looking thin. Nobody tells you that without a plan, Kansas Medicaid rules can require you to spend down nearly everything you own before your spouse qualifies for a single dollar of government help.

Here is what you need to know before that happens.

The Myth That Destroys Kansas Families

Most people assume Medicare will cover long-term care. It will not. Medicare covers an average of just 22 days in a rehabilitation facility, and even then only under specific conditions. After that, you are on your own.

The other assumption people make is that Medicaid is only for people who have nothing. That is also wrong. Medicaid is the primary payer for long-term care in the United States, and it is available to people with significant assets, but only after those assets have been divided and managed according to the rules.

In Kansas, nearly 70% of people who turn 65 will need some form of long-term care. The average cost runs close to $100,000 a year. Without planning, that math leads to one place: financial devastation for the spouse left at home.

How Kansas Medicaid Actually Works for Married Couples

When one spouse enters a nursing home or memory care facility, Kansas Medicaid requires a full accounting of the couple's combined assets. Those assets get divided into two categories: “exempt” assets and “countable” assets.

Countable assets get cut in half. The healthy spouse, called the Community Spouse, is allowed to keep up to a maximum of $162,660 under current Kansas rules. The institutionalized spouse must spend the remaining balance to below $2,000 before Medicaid will pay anything. This is what's called the “spend down.”

So, if you have $500,000 in countable assets, here is what that looks like:

• You keep $162,660

• Your spouse's share is roughly $337,340

• That $337,340 has to be addressed before Medicaid steps in

At $9,000 a month, that is nearly three years of out of pocket expense; three years of watching your retirement disappear.

What "Exempt" Actually Means — and Why It Matters

Not everything you own counts against Medicaid eligibility. Some assets are exempt, meaning Medicaid does not consider them when calculating your spouse's spend-down requirement.

Common exempt assets in Kansas include your primary home (in most cases), one vehicle, certain personal property, and income-producing assets. However, assets being exempt for qualification does not mean the assets are safe. If the assets are improperly titled, Medicaid Estate Recovery Services may attach a lien to the property to recover their costs.

This is why asset titling matters so much, and why working with an elder law attorney before a crisis happens is so different from calling one after a Medicaid application has been submitted. The planning options are not the same.

The Strategy That Protects Everything

For married couples in crisis, the most powerful tool available is something called a Medicaid-compliant annuity (MCA). Most annuities are treated as countable assets by Medicaid. But a MCA is different. If the contract includes five specific provisions required by federal law, Medicaid treats the annuity as an income stream rather than an asset.

Here is why that matters. Once you convert your spouse's countable share into a MCA, that money is no longer sitting on your spouse’s balance sheet as an asset. Your spouse can qualify for Medicaid immediately.

The annuity then pays that money back to you, the Community Spouse, in monthly installments, over a set period of time. By the end of the payout, the money is back in your hands. You have lost nothing except attorney’s fees and the payments made to the facility, while the Medicaid application was processed.

This is not a loophole. It is a legal planning strategy built into federal Medicaid law specifically to protect the community spouse from impoverishment.

What This Costs and What It Saves

In 2026, Attorney fees at Advanced Legal Planning for this type of planning run between $9,000 and $15,000 depending on complexity. Simple cases with straightforward assets start at $9,000. More complex situations with multiple asset types, rental properties, or business interests typically run $12,000 to $15,000.

The alternative is spending down anywhere from hundreds of thousands to several million dollars before Medicaid pays anything.

The decision tends to be a straightforward one once you see the numbers side by side.

The Window Does Not Stay Open

The biggest mistake families make is waiting. Every month of unplanned private pay is money that did not have to leave your family. And while some planning can still be done after a spouse enters a facility, the options narrow quickly.

For a deeper look at how this strategy played out in a real Kansas case, read how one Kansas couple protected over $3 million from Medicaid spend-down.

To understand the full picture of Medicaid planning options in Kansas, visit our Elder Law and Medicaid Planning page.

For Kansas-specific Medicaid eligibility rules and long-term care coverage details, the Kansas Department for Aging and Disability Services is the official state resource. For a broader look at what long-term care actually costs across the country, the AARP Long-Term Care Cost Calculator gives a clear, up-to-date picture of what families are really facing.

Ready to find out what is possible for your family? Call Advanced Legal Planning at (316) 252-2233 or schedule a consultation online. Virtual meetings are available.