How Medicaid’s Minimum Monthly Maintenance Needs Allowance Works & 2022 Limits

Last updated: December 06, 2021

 

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. To be very clear, spousal impoverishment 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 is intended for non-applicant spouses who have little to no monthly income. Medicaid’s income limit is fairly restrictive, so this rule is in place to ensure the non-applicant spouse is left with sufficient income. In order to receive this spousal income allowance, the community spouse’s monthly income must fall under a specified level.

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) is another spousal impoverishment provision. The CSRA protects a certain amount of the couple’s resources for the community spouse. Only the MMMNA will be covered in this article, but one can learn more about the CSRA here.

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Min. and Max. MMMNA Figures for 2022

The Minimum Monthly Maintenance Needs Allowance (effective 7/1/21 – 6/30/22) is $2,177.50 in 48 states and the District of Columbia. Based on the state, this figure may be rounded up to $2,178.00. Due to the higher cost of living, Hawaii has a MMMNA of $2,505.00, and Alaska has a MMMNA of $3,435. These figures are set by the federal government and are based on the Federal Poverty Level.

The Maximum Monthly Maintenance Needs Allowance (effective 1/1/22 – 12/31/22) is $3,435. This figure is calculated based on the SSI Federal Benefit Rate (FBR).

While the majority of the states utilize both the federally set Minimum and Maximum Monthly Maintenance Needs Allowance figures, Wisconsin is an exception. WI does not use the minimum income allowance of $2,177.50 and instead sets their minimum at $2,903.45. However, the state’s maximum remains at the federally set limit of $3,435 / month. Other states utilize only a standard figure as the Monthly Maintenance Needs Allowance. In these states, that figure falls somewhere between the federally set minimum of $2,177.50 and the maximum of $3,435. For example, in 2022, New York, Texas, and California all use a standard monthly figure of $3,435, and Illinois uses a standard monthly figure of $2,739.

 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.  
2022 Min. and Max. Monthly Maintenance Needs Allowance Figures by State
Arkansas $2,177.50 – standard figure
Alaska $3,435
Arizona $2,177.50 – $3,435
Arkansas $2,177.50 – $3,435
California $3,435 – standard figure
Colorado $2,177.50 – $3,435
Connecticut $2,177.50 – $3,435
Delaware $2,177.50 – $3,435
District of Columbia $2,177.50 – $3,435
Florida $2,177.50 – $3,435
Georgia $3,435 – standard figure
Hawaii $2,505 – $3,435
Idaho $2,177.50 – $3,435
Illinois $2,739 – standard figure
Indiana $2,177.50 – $3,435
Iowa $3,435 – standard figure
Kansas $2,177.50 – $3,435
Kentucky $2,177.50 – $3,435
Louisiana $3,435 – standard figure
Maine $2,177.50 – $3,435
Maryland $2,177.50 – $3,435
Massachusetts $2,177.50 – $3,435
Michigan $2,177.50 – $3,435
Minnesota $2,177.50 – $3,435
Mississippi $3,435 – standard figure
Missouri $2,177.50 – $3,435
Montana $2,177.50 – $3,435
Nebraska $2,177.50 – $3,435
Nevada $2,177.50 – $3,435
New Hampshire $2,177.50 – $3,435
New Jersey $2,177.50 – $3,435
New Mexico $2,177.50 – $3,435
New York $3,435 – standard figure
North Carolina $2,177.50 – $3,435
North Dakota $2,550 – standard figure
Ohio $2,177.50 – $3,435
Oklahoma $3,435 – standard figure
Oregon $2,177.50 – $3,435
Pennsylvania $2,177.50 – $3,435
Rhode Island $2,177.50 – $3,435
South Carolina $3,435 – standard figure
South Dakota $2,177.50 – $3,435
Tennessee $2,177.50 – $3,435
Texas $3,435 – standard figure
Utah $2,177.50 – $3,435
Vermont $2,178 – $3,435
Virginia $2,177.50 – $3,435
Washington $2,177.50 – $3,435
West Virginia $2,177.50 – $3,435
Wisconsin $2,903.45 – $3,435
Wyoming $3,435 – standard figure

 

Calculating the MMMNA

In states that use a standard Monthly Maintenance Needs Allowance, a non-applicant spouse is entitled to monthly income from their applicant spouse if their income falls under the standard figure. As an example, Georgia uses a standard figure of $3,435 / month. A non-applicant spouse in GA with a monthly income of $1,000 is automatically entitled to $2,435 / month from their applicant spouse to bring their income up to $3,435 / month.

In states that use both a Minimum and Maximum Monthly Maintenance Needs Allowance, 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 minimum figure is $2,177.50 / month. If a non-applicant spouse in PA has a monthly income of $1,600, they are able to receive $577.50 / month from their applicant spouse, increasing their income to the MMMNA of $2,177.50. However, the state also utilizes a Maximum Monthly Maintenance Needs Allowance of $3,435. Based on one’s shelter and utility costs, a non-applicant spouse may be entitled to an even greater Monthly Maintenance Needs Allowance. This 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 allowance.

The shelter allowance is $653.25 / month (effective 7/1/21 – 6/30/22) for 48 states, as well as the District of Columbia. Some states round this figure to $654 / month. In Hawaii, the shelter allowance is set at $751.50 / month. These figures are based on a percentage 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 housing allowance. If a community spouse’s shelter costs are greater than the set monthly housing 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 shelter allowance, one’s spousal allowance will be increased by $150 / month. However, the maximum monthly income to which a community spouse is entitled, regardless of shelter costs, is the Maximum Monthly Maintenance Needs Allowance of $3,435.

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, which is established by each state. 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.

2022 Medicaid’s Standard Utility Allowance by State
Arkansas Not relevant
Alaska Not relevant
Arizona $288
Arkansas $281
California Not relevant
Colorado $493
Connecticut $783
Delaware $425
District of Columbia Unknown
Florida $366
Georgia Not relevant
Hawaii Unknown
Idaho $361
Illinois Not relevant
Indiana $417
Iowa Not relevant
Kansas $392
Kentucky $325
Louisiana Not relevant
Maine $844
Maryland $388
Massachusetts $688
Michigan $559
Minnesota $488
Mississippi Not relevant
Missouri $415
Montana $600
Nebraska $511
Nevada $284
New Hampshire $757
New Jersey $548
New Mexico $385
New York Not relevant
North Carolina $440
North Dakota Not relevant
Ohio $580
Oklahoma Not relevant
Oregon $450
Pennsylvania $612
Rhode Island $676
South Carolina Not relevant
South Dakota $784
Tennessee $317
Texas Not relevant
Utah $376
Vermont $875
Virginia $322
Washington $459
West Virginia $436
Wisconsin $462
Wyoming Not relevant

 

MMMNA 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 $2,600 / month in income, and Rose’s monthly income is $841. In Florida, the Minimum Monthly Maintenance Needs Allowance is set at $2,177.50 and the Maximum Monthly Maintenance Needs Allowance is $3,435. Since Rose’s income of $841 / month is under the MMMNA of $2,177.50, she is automatically entitled to $1,336.50 / month of John’s income to bring her income level up to the MMMNA of $2,177.50.

In Florida, the Community Spouse Monthly Housing Allowance is set at $654 / month and the Standard Utility Allowance (SUA) is $366 / 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 $366 / month is added to her monthly shelter costs. ($1,750 + $366 = $2,116 / month in total shelter costs). Since her total monthly shelter cost is over the standard monthly housing allowance of $654, this figure is deducted from Rose’s monthly shelter costs. ($2,116 / month – $654 / month = $1,462 / month in which Rose is entitled in shelter costs).

We already mentioned that Rose is entitled to $1,336.50 / month to bring her income level up to the MMMNA of $2,177.50. With the additional $1,462 / month for excess shelter costs, this brings the total amount to $2,798.50 / month. ($1,336.50 + $1,462 = $2,798.50)

However, with Rose’s own income ($841 / month) and the income to which she is entitled from her institutionalized spouse ($1,336.50 to reach the MMMNA and $1,462 in excess shelter costs = $2,798.50), her total monthly income would come to $3,639.50. Since this figure is over the Maximum Monthly Maintenance Needs Allowance of $3,435 in Florida, she is entitled only to $2,594 / month from her institutionalized spouse, bringing her total income to $3,435 / 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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