MMMNA: How It’s Calculated, 2026 Amounts, and Fair Hearings

The Minimum Monthly Maintenance Needs Allowance, or MMMNA, is the amount of monthly income Medicaid lets the at-home spouse keep when their partner enters a nursing home on Medicaid. For most of 2026, that protected floor is $2,705 a month, and it can rise as high as $4,066.50 when housing costs are high enough to justify the increase.¹ Congress created the allowance in 1988 to prevent what lawmakers called “spousal impoverishment.”²

Who the Allowance Protects

Medicaid splits a married couple into two roles once one partner needs long-term care. The institutionalized spouse is the one in a nursing facility or receiving equivalent care through a Medicaid home-and-community-based services waiver. The community spouse is the one still living at home. The MMMNA exists for the community spouse’s benefit.²

The couple must be legally married, the institutionalized spouse must meet Medicaid’s medical and financial eligibility rules, and the community spouse must be living somewhere other than a medical institution. If both spouses are in nursing facilities, neither counts as a community spouse and the MMMNA doesn’t apply.²

How the Number Is Calculated

The allowance has two moving parts: a base amount, and an add-on for high housing costs.

The Base

Federal law sets the base at 150 percent of one-twelfth of the federal poverty line for a two-person household.³ For 2026, the two-person poverty guideline is $21,640, which produces a monthly base of $2,705. The base refreshes each July when new poverty guidelines take effect.¹

The Excess Shelter Allowance

If the community spouse’s housing costs run higher than 30 percent of the base ($811.50 a month in 2026), the excess is added on top. Qualifying housing costs include rent or mortgage, property taxes, homeowner’s insurance, and required condo or co-op fees. Utilities are counted through a Standard Utility Allowance (the same fixed figure the state uses for SNAP), or through actual utility bills in states that don’t use the standard credit.³

A worked example. Suppose the community spouse pays $1,800 a month between mortgage, taxes, insurance, and the utility allowance. Subtract the $811.50 threshold and $988.50 is left over. That $988.50 gets added to the $2,705 base, producing an MMMNA of $3,693.50. No matter how large the housing costs get, the total cannot cross the federal ceiling.

2026 Dollar Amounts

The Centers for Medicare & Medicaid Services publishes updated figures each year. For most of 2026:

Minimum MMMNA effective July 1, 2026: $2,705 per month in the 48 contiguous states, $3,381.25 in Alaska, and $3,111.25 in Hawaii.
Maximum MMMNA: $4,066.50 per month.

The minimum updates each July with the new poverty guidelines. The maximum updates each January based on changes in the Consumer Price Index.¹ Between January and June 2026, the older $2,643.75 minimum from the prior year’s poverty guidelines still applies, while the maximum has already stepped up to $4,066.50.⁴

States have some room to set their own MMMNA anywhere between the federal floor and ceiling. A few states default straight to the maximum, so every community spouse there gets the full $4,066.50 without documenting shelter costs. Most states start at the minimum and layer on the excess shelter allowance from there.

How the Income Actually Moves Between Spouses

The MMMNA is a target, not an automatic payment. If the community spouse’s own income already meets or exceeds the MMMNA, nothing transfers. The allowance only matters when the community spouse’s independent income falls short.

When there is a gap, the institutionalized spouse’s income fills it. Each month the state runs what Medicaid calls the post-eligibility treatment of income to decide how much of the nursing home resident’s income goes toward care.⁵ The community spouse’s allowance is deducted before the payment to the facility.

Say the community spouse has $1,200 in monthly Social Security and the MMMNA is $2,705. The institutionalized spouse redirects $1,505 of their income each month to make up the shortfall. After that transfer and a small personal needs allowance (the federal minimum is $30 a month, though most states set it higher), whatever remains of the institutionalized spouse’s income becomes their patient pay amount and goes to the nursing home.

One important limit: if the institutionalized spouse doesn’t have enough income to bring the community spouse up to the MMMNA, Medicaid does not make up the rest. The community spouse simply receives whatever’s available. Federal law is also clear that income paid in one spouse’s name belongs to that spouse. The community spouse’s Social Security check, pension, or investment income is not treated as available to the institutionalized spouse.²

Asking for More Through a Fair Hearing

The standard formula doesn’t always match real life. Federal law gives either spouse the right to request a fair hearing challenging the allowance, and the statute specifically allows a higher amount when the community spouse can show “exceptional circumstances resulting in significant financial duress.”³

A hearing can be requested once a Medicaid application has been filed for the institutionalized partner. Situations that commonly justify an increase include large out-of-pocket medical expenses for the community spouse, emergency home repairs, or ongoing care costs for a dependent family member. Documentation has to be specific: receipts, medical bills, contractor estimates, and similar records showing the standard allowance leaves the community spouse unable to cover basic obligations.

A court order for spousal support can also override the standard calculation. If a family court orders a higher monthly support amount, the Medicaid agency must honor that figure when computing the income transfer.³

Mistakes That Cost Couples Money

The most expensive error is failing to document housing costs. In most states, the MMMNA starts at the federal floor and only rises with a proven excess shelter allowance. A community spouse paying $2,200 a month for housing and utilities who submits nothing gets the base $2,705 rather than something close to the $4,066.50 maximum. That’s over $1,300 a month left on the table.

A related mistake is assuming the community spouse’s own income has to be handed over to help pay the facility. It doesn’t. Income in the community spouse’s name stays with the community spouse.²

Couples also routinely skip the fair hearing process even when they have a strong case. The exceptional-circumstances provision exists for exactly the situations the formula can’t anticipate, and the relief can be substantial when the documentation supports it.

One boundary worth naming: the MMMNA protects monthly income only. A separate rule, the Community Spouse Resource Allowance, protects a portion of the couple’s assets, and it operates on its own set of numbers and procedures. If the question is about how much the community spouse can keep in savings or investments rather than how much monthly income they can receive, that’s a different calculation.

1
Centers for Medicare & Medicaid Services. 2026 SSI and Spousal Impoverishment Standards
2
Medicaid. Spousal Impoverishment
3
Office of the Law Revision Counsel. 42 USC 1396r-5 – Treatment of Income and Resources for Certain Institutionalized Spouses
4
Centers for Medicare & Medicaid Services. Updated 2025 SSI and Spousal Impoverishment Standards
5
eCFR. 42 CFR 435.725 – Post-Eligibility Treatment of Income of Institutionalized Individuals in SSI States