Short answer: Yes. If the at-home spouse’s own income is below the monthly maintenance needs allowance ($4,066.50 per month in Texas for 2026), part of the nursing home spouse’s income can be paid to the at-home spouse instead of to the facility.
The spouse at home keeps all of their own income; it is not counted toward the nursing home spouse’s eligibility. Income is attributed by whose name is on the check, and income paid in both names is split in half.
When the at-home spouse’s income is low, the federal spousal impoverishment rules let the resident divert income to them. Texas’s 2026 Minimum Monthly Maintenance Needs Allowance (HHSC also calls it the Spousal Allowance) is $4,066.50 per month. The amount diverted is the gap between that figure and the at-home spouse’s own income.
Example: an at-home spouse with $1,500 per month of their own income can receive up to $2,566.50 per month from the resident’s income.
A separate dependent allowance applies for certain dependent family members living with the spouse at home (figured from a $2,705 base effective 07-01-2026, less the dependent’s own income, divided by three, per HHSC’s handbook). These are not automatic; they are applied in HHSC’s co-payment budget.