If an applicant for Medicaid is married, the applicant’s spouse is entitled to receive a certain level of monthly income. The Medicaid term for that income allowance is the “monthly maintenance needs allowance” or “MMNA” for short.
Most people need to know just three things about the MMNA.
First, the Medicaid applicant’s spouse must be a “community spouse” in order to receive a MMNA.
Second, the amount of the MMNA approved by the state will be somewhere between the current minimum and maximum allowances. (As of January 1, 2019, those figures are: minimum, $2,058; maximum, $3,160.50. To make sure you always have the current figures, bookmark the Medicaid Current Numbers page of our website.)
Each community spouse’s MMNA will be different, and will depend on the community spouse’s shelter costs, including rent, mortgage, homeowner’s insurance, taxes, utilities, and so forth. A homeowner with no mortgage and low property taxes tends to have a MMNA closer to the minimum, while a renter tends to have a MMNA closer to the maximum.
Third, a community spouse can request a MMNA above the maximum cap if the community spouse has “exceptional circumstances resulting in significant financial duress.” (An example is a community spouse residing in an assisted living facility who cannot afford basic necessities with $3,160.50 a month.) In Pennsylvania, one must request an appeal hearing to obtain a MMNA above the maximum.
So that’s really all most people need to know about the MMNA.
But, okay, suppose you want to know the technical details because you are a lawyer, or you just love arcane minutia. In that case, read on.
The MMNA consists of two parts:
(1) a basic allowance equal to 150% of the federal poverty level for a family of two ($2,058 as of 7-1-18); and
(2) an excess shelter allowance equal to the amount by which shelter expenses exceed the shelter allowance ($618 as of 7-1-18). Shelter expenses are limited to rent or mortgage payments (including principal and interest), taxes and insurance, required maintenance charges for a condominium or cooperative, and an allowance for utility expenses. An applicant should be prepared to substantiate these expenses with bills for the past 12 months. To calculate the excess shelter allowance, add up all the shelter expenses, and subtract the shelter allowance:
(Shelter expenses – shelter allowance) + $2,058 = MMNA
Then make sure your figure does not exceed the maximum cap, currently $3,160.50. (Pennsylvania also requires the use of utility standards in calculating shelter expenses.)
The statute authorizing a revision of the MMNA above the maximum cap can be found at 42 U.S.C. § 1396r-5(c)(2)(B).