If a married nursing home resident receives Medicaid long-term care benefits, his or her community spouse is entitled to retain a certain minimum level of income called the Monthly Maintenance Needs Allowance (MMNA). If the community spouse's own income is insufficient to provide this allowance, income is diverted to the community spouse from the institutionalized spouse.
The MMNA is set at 150% of the federal poverty level for a family of two plus an excess shelter allowance, if applicable. The Pennsylvania MMNA is adjusted on July 1st of each year to keep up with inflation.
As of July 1, 2011 the minimum MMNA is being increased to $1,839 per month. The actual MMNA can be higher than the minimum if the community spouse has high housing cost and is entitled to an excess shelter allowance.
A standard monthly shelter allowance of $552 a month will be built into the minimum MMNA effective July 1. If certain housing-related expenses of the community spouse exceed this standard allowance the MMNA is increased by the amount of these excess shelter costs. This is the called the "excess shelter allowance."
These minimum income allowance rules are part of the federally mandated “spousal impoverishment” protections that were enacted in 1988 to avoid the total impoverishment of spouses of nursing home residents. These protections could be lost if a Medicaid Block Grant proposal were to be enacted at the national or state level.