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Spousal refusal, in the context of health care costs, refers to a spouse's refusal to pay for long-term care expenses of the other spouse. Married people have a legal obligation to pay for the healthcare costs incurred by their spouse if they are admitted into a nursing home (with some exceptions). If your spouse has been admitted to a nursing home, by filing a form with Medicaid and stating that you refuse to pay for your spouse's care you may be able to retain more resources than you normally would be able to. The county Medicaid office has the right to seek reimbursement from the spouse who is not in the nursing home (referred to as the "community spouse"), but such lawsuits are rare.