How Medicaid’s Minimum Monthly Maintenance Needs Allowance Works & 2024 Limits

Last updated: December 27, 2023

 

What is the Minimum Monthly Maintenance Needs Allowance?

When applying for long-term care Medicaid, be that in a nursing home or for Home and Community Based Services (HCBS) in one’s home, an adult foster care home, or an assisted living residence via a Medicaid Waiver, there are income and asset limits that must be met. For married couples, with just one spouse applying for these types of benefits, there are Spousal Impoverishment Rules in place to ensure the non-applicant spouse, often called the community spouse or well spouse, has sufficient financial means from which to live. These rules do not apply when one spouse of a married couple is applying for a state’s Regular Medicaid program. For the elderly, this program is often called Aged, Blind and Disabled Medicaid.

The Minimum Monthly Maintenance Needs Allowance (MMMNA) is one Spousal Impoverishment Rule. It allows a married Medicaid nursing home applicant or HCBS Medicaid Waiver applicant to transfer a portion, or in some cases, all of their monthly income, to their non-applicant spouse. The MMMNA protects non-applicant spouses who have little to no monthly income from becoming impoverished so that their applicant spouse can meet Medicaid’s income limit; it is the minimum amount of monthly income to which the non-applicant spouse is entitled.

Relative to Spousal Impoverishment Provisions, an applicant spouse is often called the institutionalized spouse. This can be confusing since the applicant spouse does not have to be institutionalized (reside in a nursing home). Rather, the applicant spouse can receive long-term care services in their home or community via a HCBS Medicaid Waiver.

The Community Spouse Resource Allowance (CSRA), which is not covered in this article, is another Spousal Impoverishment Provision. The CSRA protects a certain amount of the couple’s resources for the non-applicant spouse.

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Min. and Max. MMMNA Figures for 2024

Federally Set Limits

Minimum Monthly Maintenance Needs Allowance (MMMNA) and Maximum Monthly Maintenance Needs Allowance figures are set by the federal government. The MMMNA is based on the Federal Poverty Level (FPL). Since both Alaska and Hawaii have a state-specific FPL, each state has a state-specific MMMNA. The Maximum Monthly Maintenance Needs Allowance is based on the SSI Federal Benefit Rate (FBR).

Minimum Monthly Maintenance Needs Allowance (effective 7/1/23 – 6/30/24)
$2,465 – includes all of the United States except Hawaii and Alaska
$2,835 – Hawaii
$3,080 – Alaska

Maximum Monthly Maintenance Needs Allowance (effective 1/1/24 – 12/31/24)
$3,853.50

 

State Specific Limits

States do not have to utilize the federally set Minimum and Maximum Monthly Maintenance Needs Allowance figures. The majority of states do, but each state has the freedom to use figures within the federally set minimum and maximum. As an example, Wisconsin sets their minimum income allowance at $3,286.66 instead of $2,465, but uses $3,853.50 as the maximum income allowance.

Other states choose to utilize one standard figure that falls between the federally set minimum and maximum figures for their Monthly Maintenance Needs Allowance. For instance, Alabama uses a standard figure of $2,465, North Dakota uses a standard figure of $2,550 / month, and Alaska, California, Hawaii, Illinois, New York, and Texas all use a standard figure of $3,853.50 / month (some states may round up to $3,854 / month).

 The income transferred from an institutionalized spouse (a spouse in a Medicaid-funded nursing home or receiving home and community based services via a Medicaid Waiver) to a community spouse does not count against Medicaid eligibility. More on how Medicaid counts income.  
2024 Min. and Max. Monthly Maintenance Needs Allowance Figures by State – Effective Jan. 1, 2024
Alabama $2,465 – standard figure
Alaska $3,853.50 – standard figure
Arizona $2,465 – $3,853.50
Arkansas $2,465 – $3,853.50
California $3,854 – standard figure
Colorado $2,465 – $3,853.50
Connecticut $2,465 – $3,853.50
Delaware $2,465 – $3,853.50
District of Columbia $3,853.50 – standard figure
Florida $2,465 – $3,854
Georgia $3,853.50 – standard figure
Hawaii $3,853.50 – standard figure
Idaho $2,465 – $3,853.50
Illinois $3,853.50 – standard figure
Indiana $2,465 – $3,854
Iowa $3,853.50 – standard figure
Kansas $2,465 – $3,853.50
Kentucky $2,465 – $3,854
Louisiana $3,853.50 – standard figure
Maine $2,465 – $3,853.50
Maryland $2,465 – $3,853.50
Massachusetts $2,465 – $3,853.50
Michigan $2,465 – $3,853.50
Minnesota $2,466 – $3,853.50
Mississippi $3,853.50 – standard figure
Missouri $2,465 – $3,854
Montana $2,465 – $3,853.50
Nebraska $2,465 – $3,854
Nevada $3,853.50– standard figure
New Hampshire $2,465 – $3,854
New Jersey $2,465 – $3,853.50
New Mexico $2,465 – $3,853.50
New York $3,853.50 – standard figure
North Carolina $2,465 – $3,853.50
North Dakota $2,550 – standard figure
Ohio $2,465 – $3,853.50
Oklahoma $3,854 – standard figure
Oregon $2,465 – $3,853.50
Pennsylvania $2,465 – $3,853.50
Rhode Island $2,465 – $3,853.50
South Carolina $3,853.50 – standard figure
South Dakota $2,465 – $3,853.50
Tennessee $2,465 – $3,853.50
Texas $3,853.50 – standard figure
Utah $2,465 – $3,853.50
Vermont $2,555 – $3,853.50
Virginia $2,465 – $3,853.50
Washington $2,465 – $3,853.50
West Virginia $2,465 – $3,853.50
Wisconsin $3,286.67 – $3,853.50
Wyoming $3,853.50 – standard figure

 

Calculating the MMMNA

In states that use one standard figure as their Monthly Maintenance Needs Allowance, a non-applicant spouse is entitled to monthly income from their applicant spouse if their income falls under that figure. As an example, Georgia uses a standard figure of $3,853.50 / month. A non-applicant spouse in GA with a monthly income of $1,000 is automatically entitled to $2,853.50 / month from their applicant spouse to bring their income up to $3,853.50 / month.

In states that use both Minimum and Maximum Monthly Maintenance Needs Allowance figures, the applicant spouse can automatically transfer monthly income to their non-applicant spouse to bring that spouse’s income up to the Minimum Monthly Maintenance Needs Allowance. For instance, in Pennsylvania, the MMMNA is $2,465 / month. If a non-applicant spouse in PA has a monthly income of $1,600, they are able to receive $865 / month from their applicant spouse, increasing their income to the MMMNA of $2,465. Since the state also utilizes a Maximum Monthly Maintenance Needs Allowance of $3,853.50, a non-applicant spouse may be entitled to an even greater Monthly Maintenance Needs Allowance. This is based on one’s shelter and utility costs and is covered in the following section.

 

Is it Possible to Transfer More Monthly Income?

Yes, in some cases, a Medicaid applicant spouse may transfer monthly income greater than the Minimum Monthly Maintenance Needs Allowance to their non-applicant spouse. However, this is only possible in states that use both a Minimum Monthly Maintenance Needs Allowance and a Maximum Monthly Maintenance Needs Allowance.

In determining if a non-applicant can have a higher Spousal Income Allowance than a state’s minimum needs allowance, the non-applicant’s “shelter” costs are taken into account.

Monthly Housing Allowance

The Community Spouse Monthly Housing Allowance, also called a Shelter Standard or Excess Shelter Allowance, includes expenses such as rent, mortgage, property taxes, and homeowners’ insurance. Based on the community spouse’s actual shelter costs and the federally set housing allowance, they might be entitled to a higher Spousal Income Allowance.

The Excess Shelter Allowance is $739.50 / month (effective 7/1/23 – 6/30/24) for 47 states, as well as the District of Columbia. Some states round this figure to $740 / month. While the federal government sets a different Excess Shelter Allowance for Alaska and Hawaii, it is not relevant since these states use a standard Monthly Maintenance Needs Allowance figure. Excess Shelter Allowance figures are based on 30% of the Minimum Monthly Maintenance Needs Allowance.

Very generalized, it is assumed that a community spouse has sufficient funds in which to pay their shelter expenses if their income is equivalent to the MMMNA and their shelter costs do not exceed the monthly Excess Shelter Allowance. If a community spouse’s shelter costs are greater than the Excess Shelter Allowance in their state, they are entitled to a greater Monthly Maintenance Needs Allowance. For instance, if one’s shelter costs are $150 / month over the Excess Shelter Allowance, one’s Spousal Income Allowance will be increased by $150 / month. The maximum monthly income to which a community spouse is entitled, regardless of shelter costs, is the Maximum Monthly Maintenance Needs Allowance of $3,853.50.

 

Standard Utility Allowance

A Standard Utility Allowance (SUA) can be added to one’s shelter costs, which can further increase one’s Spousal Income Allowance. The SUA is an average monthly utility cost. It is established by each state and is generally updated each October. Utilities that are considered may include cooling/heating, electricity, basic phone service, sewage, garbage, and water. This figure may vary based on if one pays heating and cooling costs separately from their rent and what other utilities one pays.

2024 Medicaid’s Standard Utility Allowance by State (Updated Dec. 19, 2023)
Alabama Not relevant
Alaska Not relevant
Arizona $318
Arkansas $329
California Not relevant
Colorado $560
Connecticut $912
Delaware $534
District of Columbia Not relevant
Florida $426
Georgia Not relevant
Hawaii Not relevant
Idaho $376
Illinois Not relevant
Indiana $502
Iowa Not relevant
Kansas $462
Kentucky $452
Louisiana Not relevant
Maine $1,011
Maryland $551
Massachusetts $852
Michigan $680
Minnesota $651
Mississippi Not relevant
Missouri $475
Montana $723
Nebraska $580
Nevada N/A
New Hampshire $956
New Jersey $850
New Mexico $417
New York Not relevant
North Carolina $585
North Dakota Not relevant
Ohio $724
Oklahoma Not relevant
Oregon $469
Pennsylvania $750
Rhode Island $797
South Carolina Not relevant
South Dakota $892
Tennessee $430
Texas Not relevant
Utah $503
Vermont $1,020
Virginia $414
Washington $483
West Virginia $496
Wisconsin $502
Wyoming Not relevant
MMNA Calculation Example
 Example

John and Rose live in Florida. John has Alzheimer’s disease, requires 24-hour supervision, and recently relocated to a Medicaid funded nursing home. John has $2,700 / month in income, and Rose’s monthly income is $943. In Florida, the Minimum Monthly Maintenance Needs Allowance is $2,465 and the Maximum Monthly Maintenance Needs Allowance is $3,853.50. Since Rose’s income of $943 / month is under the MMMNA of $2,465, she is automatically entitled to $1,522 / month of John’s income to bring her income level up to $2,465.

In Florida, the Community Spouse Monthly Housing Allowance is $740 / month and the Standard Utility Allowance (SUA) is $426 / month.

Rose has a mortgage and real estate tax payment of $1,650 / month and a homeowners insurance payment of $100 / month, for a total of $1,750 / month. Rose pays for heating and cooling of her home, so a SUA of $426 / month is added to her monthly shelter costs. ($1,750 + $426 = $2,176 / month in total shelter costs). Since her total monthly shelter cost is over the standard monthly housing allowance of $740, this figure is deducted from Rose’s monthly shelter costs. ($2,176 / month – $740 / month = $1,436 / month in which Rose is entitled in shelter costs).

We already mentioned that Rose is entitled to $1,522 / month to bring her income level up to the MMMNA of $2,465. With the additional $1,436 / month for excess shelter costs, this brings the total amount to $2,958 / month ($1,552 + $1,436 = $2,958).

However, with Rose’s own income ($943 / month) and the income to which she is entitled from her institutionalized spouse ($1,522 to reach the MMMNA and $1,436 in excess shelter costs = $2,958), her total monthly income would come to $3,901. Since this figure is over the Maximum Monthly Maintenance Needs Allowance of $3,853.50 in Florida, she is entitled only to $2,910.50 / month from her institutionalized spouse, bringing her total income to $3,853.50 / month.

 

 

Help Determining MMMNA & Qualifying for Medicaid

When only one spouse of a married couple applies for Nursing Home Medicaid or a HCBS Medicaid Waiver, it can be a complicated process. It is highly advised one seek the counsel of a Medicaid expert in this situation. Professional Medicaid Planners can offer assistance in maximizing the amount of income a non-applicant spouse receives. Furthermore, they can help the non-applicant spouse preserve a greater amount of the couple’s joint assets while easing the application process and increasing the likelihood the applicant spouse will qualify for Medicaid. Locate a Medicaid Planner here.

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