When a resident of an assisted living facility receives Medicaid assistance, then virtually all of his or her income must be paid to the facility each month. That person, however, is allowed to use his or her income to pay for a health insurance premium. The resident of an assisted living facility is also allowed to keep an allowance. According to the New Jersey Medicaid regulations, this allowance is referred to as a “Monthly Maintenance Needs Allowance” and is commonly referred to as a Personal Needs Allowance or PNA.
In 2022 the PNA for an assisted living resident was $124.70. The PNA has increased by almost 9% in 2023. On December 20, 2022, the New Jersey Division of Medical Assistance and Health Services (DMAHS) issued a directive known as Medicaid Communication No. 23-01. According to this directive from the DMAHS, the new PNA for 2023 is $135.80.
The Personal Needs Allowance, or PNA, for a nursing home resident is $50.00. The PNA of $50.00 has not increased in the past six years. A resident of an assisted living facility can keep close to $86.00 more of his or her income.
By way of illustration, if a resident of an assisted living facility has a monthly income of $1,500.00 and assuming that his or her health insurance premium is $250.00 per month, then the cost share owed to the assisted living facility is $1,114.20. This was calculated by taking the gross monthly income of $1,500.00 and deducting the health insurance premium of $250.00, as well as the PNA of $135.80 to arrive at a monthly cost share of $1,114.20.