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.
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 7/1/24 – 6/30/25)
$2,555 – includes all of the United States except Hawaii and Alaska
$2,937.50 – Hawaii
$3,192.50 – 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 $3,406.66 instead of $2,555, 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 and North Dakota use a standard figure of $2,555, 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).
| 2024 Min. and Max. Monthly Maintenance Needs Allowance Figures by State – Effective July 1, 2024 | |
| Alabama | $2,555 – standard figure |
| Alaska | $3,853.50 – standard figure |
| Arizona | $2,555 – $3,853.50 |
| Arkansas | $2,555 – $3,853.50 |
| California | $3,854 – standard figure |
| Colorado | $2,555 – $3,853.50 |
| Connecticut | $2,555 – $3,853.50 |
| Delaware | $2,555 – $3,853.50 |
| District of Columbia | $3,853.50 – standard figure |
| Florida | $2,555 – $3,854 |
| Georgia | $3,853.50 – standard figure |
| Hawaii | $3,853.50 – standard figure |
| Idaho | $2,555 – $3,853.50 |
| Illinois | $3,853.50 – standard figure |
| Indiana | $2,555 – $3,854 |
| Iowa | $3,853.50 – standard figure |
| Kansas | $2,555 – $3,853.50 |
| Kentucky | $2,555 – $3,854 |
| Louisiana | $3,853.50 – standard figure |
| Maine | $2,555 – $3,854 |
| Maryland | $2,555 – $3,853.50 |
| Massachusetts | $2,555 – $3,853.50 |
| Michigan | $2,555 – $3,853.50 |
| Minnesota | $2,555 – $3,853.50 |
| Mississippi | $3,853.50 – standard figure |
| Missouri | $2,555 – $3,854 |
| Montana | $2,555 – $3,853.50 |
| Nebraska | $2,555 – $3,854 |
| Nevada | $3,853.50– standard figure |
| New Hampshire | $2,555 – $3,854 |
| New Jersey | $2,555 – $3,853.50 |
| New Mexico | $2,555 – $3,853.50 |
| New York | $3,853.50 – standard figure |
| North Carolina | $2,555 – $3,853.50 |
| North Dakota | $2,555 – standard figure |
| Ohio | $2,555 – $3,853.50 |
| Oklahoma | $3,854 – standard figure |
| Oregon | $2,555 – $3,853.50 |
| Pennsylvania | $2,555 – $3,853.50 |
| Rhode Island | $2,555 – $3,853.50 |
| South Carolina | $3,853.50 – standard figure |
| South Dakota | $2,555 – $3,853.50 |
| Tennessee | $2,555 – $3,853.50 |
| Texas | $3,853.50 – standard figure |
| Utah | $2,555 – $3,854 |
| Vermont | $2,555 – $3,853.50 |
| Virginia | $2,555 – $3,853.50 |
| Washington | $2,555 – $3,853.50 |
| West Virginia | $2,555 – $3,853.50 |
| Wisconsin | $3,406.66 – $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 $2,555 / month. If a non-applicant spouse in PA has a monthly income of $1,600, they are able to receive $955 / month from their applicant spouse, increasing their income to the MMMNA of $2,555. 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 $766.50 / month (effective 7/1/24 – 6/30/25) for 48 states, as well as the District of Columbia. Some states round this figure to $767 / 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 | $473 (eff. 5/1/24 – 4/30/25) |
| 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
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 $2,555 and the Maximum Monthly Maintenance Needs Allowance is $3,853.50. Since Rose’s income of $943 / month is under the MMMNA of $2,555, she is automatically entitled to $1,612 / month of John’s income to bring her income level up to $2,555.
In Florida, the Community Spouse Monthly Housing Allowance is $766.50 / 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 $766.50, this figure is deducted from Rose’s monthly shelter costs. ($2,176 / month – $766.50 / month = $1,409.50 / month in which Rose is entitled in shelter costs).
We already mentioned that Rose is entitled to $1,612 / month to bring her income level up to the MMMNA of $2,555. With the additional $1,409.50 / month for excess shelter costs, this brings the total amount to $3,021.50 / month ($1,612 + $1,409.50 = $3,021.50).
However, with Rose’s own income ($943 / month) and the income to which she is entitled from her institutionalized spouse ($1,612 to reach the MMMNA and $1,409.50 in excess shelter costs = $3,021.50), her total monthly income would come to $3,964.50. 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.
What if the MMMNA is Still Not Enough?
It may be possible to have a non-applicant spouse’s Monthly Maintenance Needs Allowance increased by requesting a Medicaid fair hearing, also known as an “appeal”. Through this administrative process, decisions made by one’s state Medicaid agency can be challenged, and potentially changed.
To have the MMNA increased, with the exception of a calculation error, it must be established that the non-applicant spouse’s MMMA is inadequate “due to exceptional circumstances resulting in financial duress”. An “exceptional circumstance” is one in which the non-applicant spouse has an expense that must be paid, and it was not taken into consideration when establishing the MMNA. Examples include a medical expense, credit card debt acquired prior to the need for long-term care, and the financial responsibility of caring for an immediate family member, such as a sibling. “Financial duress” results when one does not have enough funds to pay the extra financial obligation, as well as their living expenses.
Everyone has a right to a fair hearing, and one’s state Medicaid agency is required to provide information regarding this right to all Medicaid applicants / beneficiaries. This information, which is state-specific, includes how to request a fair hearing and how quickly this request must be made (generally 30-90 days of a Medicaid decision). For information on fair hearings in a specific state, one should contact that state’s Medicaid agency.
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.