If a spouse requires long-term care then Medicaid has strict rules with respect to resource and income eligibility. After the family’s resources are spent down, then the institutionalized spouse will be entitled to Medicaid assistance to pay for his or her long-term care needs. The institutionalized spouse’s monthly income must be paid to the nursing home facility, although Medicaid allows for the payment of the health insurance premium and possibly spousal support.
The healthier spouse is known as the “community spouse”. According to the Medicaid rules, the community spouse may be entitled to spousal support if his or her monthly income is below a minimum amount known as the minimum monthly maintenance needs allowance. This is commonly referred to as the “MMMNA”. The MMMNA has increased as of July 1, 2023 due to the change in the federal poverty level for a couple.
According to 42 U.S.C. §1396r-5 (d) (3), the MMMNA is calculated by multiplying the federal poverty level for a couple by a percentage set by the State. For more than 30 years the percentage must be at least 150% of the poverty line for a family of two. Commencing July 1, 2023, the MMMNA is $2,465.00.
According to the Department of Health and Human Services, the poverty income guideline for the 48 contiguous states provides that the poverty guideline is $19,720.00 for a couple. Therefore, the MMMNA is calculated as follows:
$19,720.00 x 150% = $2,464.9999
12 months
The New Jersey Division of Medical Assistance and Health Services, known as the DMAHS, has issued a directive to all 21 counties in New Jersey concerning the new MMMNA. On May 25, 2023 the DMAHS issued Medicaid Communication No. 23-05. According to Medicaid Communication No. 23-05, the MMMNA is $2,465.00 as of July 1, 2023.
By way of illustration, if the community spouse has a gross monthly income of $1,000.00 and the institutionalized spouse has a gross monthly income of $3,000.00, then the community spouse should be entitled to spousal support. The community spouse should be entitled to receive support of $1,465.00 from the institutionalized spouse. The MMMNA of $2,465.00 less the community spouse’s own income of $1,000.00 results in a shortage of $1,465.00. This would be the amount of the spousal support due from the institutionalized spouse.
The spousal support can be increased based upon shelter expenses. Therefore, the actual amount of spousal support will be based upon the community spouse’s shelter expenses in addition to the MMMNA.
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