Medicaid’s Minimum & Maximum Monthly Maintenance Needs Allowance (MMMNA)

The Minimum Monthly Maintenance Needs Allowance (MMMNA) is a Medicaid rule that comes into play when one spouse of a married couple moves into a nursing home and the other remains at home. The spouse moving to a home (“institutionalized spouse”) must surrender all their income to Medicaid which may prevent the non-applicant spouse (“wellspouse”) from having sufficient income on which to live. The MMMNA allows the applicant spouse to transfer income to the non-applicant spouse so that have sufficient income to pay rent, mortgage, utilities etc.

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Last Updated: Feb 16, 2022
DefinitionHow It WorksMin. & Max Values for 2022


Definition of Minimum & Maximum Monthly Maintenance Needs Allowance

The Minimum Monthly Maintenance Needs Allowance, or MMMNA, is a “spousal impoverishment rule” that allows the Medicaid recipient or applicant to transfer some of their income to the ‘community or non-Medicaid spouse. Since Medicaid has heavy restrictions on how to qualify, including income and asset limits, this method allows non-institutionalized spouses to have sufficient funds while still enabling the spouse in need of care to be eligible for the care they require.

These rules became enacted in 1988 because of spouses living impoverished or low-quality lives as their partners became eligible for services. It was often the case that the husband had worked, earned the majority of a couple’s income, and if that husband needed care and had to surrender their income to Medicaid, the wife was often left without sufficient income. Of course, the genders could be reversed but it was often the case in the older generations where the man worked outside the home and the woman raised the family.

There is also a Standard Utility Allowance (SUA) that may be considered when establishing one’s Minimum Monthly Maintenance amount. The SUA calculates the average utility cost and gets added to the monthly allowance. Examples of these types of expenses include electric, phone, and water bills. Each state calculates this allowance differently but can increase the amount a spouse receives for their maintenance costs. If there are bills ‘bundled’ up, this may not apply, such as in the case of apartments where many times two bills are paid as one or with rent costs.

  Medicaid limits both the applicant’s income and assets. While the MMMNA applies to income, there is a similar rule that applies to assets called the Community Spouse Resource Allowance.


How the Medicaid Monthly Maintenance Needs Allowance Works

It is easiest to describe how the Maintenance Needs Allowance is calculated by using an example.

Joe and Janine live in the state of Ohio and own a home there. Janine cannot provide all the care that Joe needs, and they have decided it is best to put him in a nursing home. Joe receives $2,200 a month in income, and Janine receives $700. As with most states, the Minimum Monthly Maintenance Needs Allowance in 2021-2022 is $2,178. Since Janine has $700 in income each month. she can have $1,478 transferred to her for her allowance to reach the MMMNA of $2,178 from Joe’s $2,200. This will allow her to receive the funds necessary to live without her spouse and not violate any Medicaid guidelines.

Now let’s look at the utilities that Janine is responsible for. Since they own their home, let’s say their real estate tax is $1,500 a month, and insurance is about $150 a month. She pays for heat. The Standard Utility Allowances is $370, so we will add this to her monthly bills ($1,500 real estate tax + $150 insurance + $370 bills), which equals $2,020. We know that the Community Spouse Monthly Housing Allowance is about $653. Since Janine’s monthly bills exceed $653, we can subtract the two and see what she can receive to cover her expenses, which would be $1,367 (monthly bills – Community Spouse Monthly Housing Allowance).

Now, we can put this all together. If Janine is entitled to $1,478 to transfer to her for expenses to bring her up to the income level of the Minimum Monthly Needs Allowance, and she can have $1,367 for shelter costs, this added together would equal $2,835. Janine’s individual income is $700. Added together, this is $3,545. The Minimum Monthly Maintenance Needs Allowance for Ohio is set at $2,178, and the Maximum Monthly Maintenance Needs Allowance is $3,435. Since she is currently getting $3,545, we know that she is over that amount and will get the maximum amount of $3,435 for her Monthly Needs Allowance.


Min. & Max Values for the Maintenance Needs Allowance 2022

The Minimum Monthly Maintenance Needs Allowance is calculated each July and is established at a federal level. All states have the same amount except for Alaska and Hawaii. From July of 2021 through June 2022, the amount was $2,178 per month. In states like Alaska and Hawaii, where the cost of living is much higher, the MMMNA is $2,721.25 and $2,505.00 per month.

With the Minimum Monthly Maintenance Needs Allowance, the Medicaid spouse can transfer the difference of funds to the community spouse. For example, say the community spouse in Michigan is receiving a monthly income of about $2,000.00. The applicant spouse can transfer the difference of $178 to them without penalty to meet the allowance threshold. However, it is important to mention that there are income limits for those on Medicaid. The Medicaid recipient can receive up to approximately $3,435 in 2022. This calculation is based on the SSI Federal Benefit Rate, which increases and is reviewed in January.

The Medicaid spouse does have options to change their maximum income amount. Many times, this is through consideration of ‘shelter’ costs, which include things such as mortgages, taxes, insurance, and utility bills such as gas. If these costs are high, then the income level may be adjusted to account for that. From July 2021 through June 2022, the amount of allowable shelter allowance is $653.25 per month. This is only applicable for states that do use a minimum and maximum amount. Not all states do. Examples are New York, Texas, and California, which just utilize one median figure as opposed to having a set minimum and maximum.