Medicaid 2023 Monthly Maintenance Needs Allowance Adjustments

Summary
Medicaid’s latest Minimum Monthly Maintenance Needs Allowance (MMMNA) standard was released on 5/11/23 by the Center for Medicaid and CHIP Services (CMCS) as part of an annual update. The new standard will go into effect on July 1, 2023. In 48 states and the District of Columbia (Alaska and Hawai’i are the exceptions), the new Minimum MMNA is $2,465.00. This represents a 7.7% increase from the previous standard of $2,288.75. Alaska’s Minimum MMNA increased to $3,080 (from $2,861.25), and Hawai’i increased to $2,835.00 (from $2,632.50). These two states are unique in this regard because the Minimum MMNA is based on the Federal Poverty Level, which is the same in 48 states and the District of Columbia, but different in Alaska and Hawai’i.

States do not have to use the Minimum MMNA set forth by the federal government. Instead, they can set their MMMNA anywhere between the federally set MMMNA and a federally set Maximum Monthly Maintenance Needs Allowance. The current Maximum MMNA of $3,715.50 is in effect until Dec. 31, 2023. Most states use the two federal government standards, but some states modify their Minimum and Maximum parameters. And some states use just one figure, rather than both Minimum and Maximum figures, which can be referred to as a “standard figure.”

A state-by-state table of Minimum and Maximum Monthly Maintenance Needs Allowance figures is included at the bottom of this article.

How the Monthly Maintenance Needs Allowance Works
Married couples with only one spouse applying for long-term care Medicaid can transfer income from the applicant spouse to the non-applicant spouse using the Monthly Maintenance Needs Allowance (MMNA). This is to prevent non-applicant spouses with little to no income of their own from becoming impoverished so the applicant spouse can become Medicaid eligible. The transferred income does not count against the income limit of the applicant spouse, so it is possible to use the MMNA as an income “spend-down” strategy for the applicant to become Medicaid eligible.

It is important to note that the MMNA can only be used by applicants for Nursing Home Medicaid or Home and Community Based Services (HCBS) Waivers. A MMNA cannot be used by applicants for Aged, Blind and Disabled (ABD) Medicaid, which is the name for state plan or Regular Medicaid for seniors.

The Minimum MMNA works like this: If the non-applicant spouse’s income is below the Minimum MMNA, the applicant spouse can transfer a portion of their income to the non-applicant spouse so their income reaches the Minimum MMNA. For example, Illinois uses a standard figure of $3,715.50, which means its Minimum MMNA is $3,715.50. If a non-applicant spouse has only $1,000 / month of income, they are entitled to $2,715.50 / month from their applicant spouse.

Maximum Monthly Needs Allowance Explained
In states that use both a Minimum and a Maximum MMNA, the applicant spouse is automatically allowed to transfer a portion of their monthly income to the non-applicant spouse so their monthly income reaches the Minimum MMNA, as described above. But here’s the difference: in states with both a Minimum and a Maximum MMNA, the applicant spouse can transfer more of their income to the non-applicant spouse, up to the Maximum MMNA, if the non-applicant’s shelter costs exceed a certain amount.

If the non-applicant spouse’s shelter costs (such as rent, mortgage, property taxes, and homeowner’s insurance, plus a preset amount for utilities) exceed the federally-set Community Spouse Monthly Housing Allowance in their state, they are entitled to a greater Monthly Maintenance Needs Allowance, up to the Maximum amount. The Community Spouse Monthly Housing Allowance was also increased in this recent federal government update, and it will be $739.50 for 48 states and the District of Columbia, effective July 1, 2023. (Alaska and Hawai’i are the exceptions). This is a 7.7% increase over the previous amount of $686.63.

While new Community Spouse Monthly Housing Allowance figures were released for Alaska ($924 – up from $858.38) and Hawaii ($850.50 – up from $789.75), these states use a standard Monthly Maintenance Needs Allowance figure. Therefore, these states do not utilize these figures.

The preset amount for utilities is known as the Standard Utility Amount, which is determined by each state. The most recent Standard Utility Allowance figures we compiled ranged from $1,075 / month in Maine to $306 / month in Arkansas. See the table below for a complete list.

In short, the Community Spouse Monthly Housing Allowance works like this: If the non-applicant spouse has shelter costs that are $200 more than the Community Spouse Monthly Housing Allowance in their state, then they are entitled to an extra $200 in monthly income from the applicant spouse via the Monthly Maintenance Needs Allowance (MMNA). If their shelter costs are $100 more, they are entitled to an extra $100. Remember, this is only relevant in states that have both a Minimum and a Maximum MMNA. It is not relevant in state’s that use only a Minimum MMNA, also known as a “standard figure,” which includes California, Texas, and New York.

Example: Calculating the Maximum Monthly Maintenance Needs Allowance
David and Linda live in Pennsylvania, which has a Minimum MMNA of $2,465 and a Maximum MMNA of $3,175.50. David has an income of $3,000 / month, and Linda’s income is $1,000 / month. David needs full-time care and is applying for Nursing Home Medicaid. The income limit for Nursing Home Medicaid in Pennsylvania is $2,742 / month, which means David’s $3,000 / month puts him over the income limit, but as long as he transfers at least $258 / month ($3,000 – $2,742 = $258) to Linda via the MMNA, he will meet the income limit.

Since Linda’s income is $1,000 / month, and Pennsylvania’s Minimum MMNA is $2,465, she is automatically entitled to $1,465 / month of David’s income ($2,465 – $1,000 = $1,465)That puts David well below the Nursing Home income limit for eligibility, but Linda may be entitled to even more than that.

The Community Spouse Monthly Housing Allowance in Pennsylvania is $739.50, and the Standard Utility Allowance is $681. Linda’s mortgage, property tax, and homeowner’s insurance payments total $1,800 per month. She also pays for heating, electricity, and water, so the $681 Standard Utility Allowance is added to her shelter costs for a total of $2,481.

Since Linda’s shelter costs are higher than Pennsylvania’s Community Spouse Monthly Housing Allowance of $739.50, Linda is able to receive additional income from David. Her excess shelter costs are $1,741.50 ($2,481 -$739.50 = $1,741.50). However, if Linda received the additional $1741.50, her total monthly income would be $4,206.50. Since this is greater than Pennsylvania’s Maximum MMNA of $3,715.50, Linda is only entitled to the amount that brings her total income to the Maximum amount of $3,715.50 / month.

Bottom line: David can transfer $2,715.50 / month of his income to add to Linda’s $1,000 / month income. This puts David will below Pennsylvania’s Nursing Home Medicaid income limit, and gives Linda a $3,715.50 / month budget to cover her living expenses.

Medicaid Monthly Maintenance Needs Allowance Standards by State

Medicaid Standard Utility Allowance by State