When one spouse enters a nursing home and applies for Medicaid, the other spouse does not have to liquidate the household to nothing. Federal spousal-impoverishment rules carve out a protected portion of the couple's assets and income — and those numbers adjusted for 2026.
The mechanism is called the Community Spouse Resource Allowance, or CSRA, and its income counterpart is the Minimum Monthly Maintenance Needs Allowance, or MMNA (sometimes written MMMNA). Together, they exist for one reason: Congress decided in 1988 that a healthy spouse should not be impoverished because their partner needs long-term institutional care.
What is the Community Spouse Resource Allowance in 2026?
The Community Spouse Resource Allowance (CSRA) is the portion of a married couple's countable assets that the at-home (community) spouse keeps when the other spouse enters a nursing home and applies for Medicaid. CMS adjusts the federal ceiling and floor each January. Verify the current 2026 figures with your state Medicaid agency before relying on any specific number.
Why The CSRA Exists
Before 1988, a couple in this situation often had to spend down nearly everything they owned before Medicaid would cover the institutionalized spouse's nursing-home stay. The community spouse — frequently a wife in her seventies, sometimes still working, sometimes not — was left with a house, a car, and almost nothing else.
Congress passed the Medicare Catastrophic Coverage Act of 1988 specifically to fix this. The CSRA and MMNA are the two protections that survived from that law and remain the backbone of spousal Medicaid planning today.
How The CSRA Is Calculated
Every state starts from the same federal framework, but states sit on a spectrum between two models. Knowing which model your state uses is the single most important fact in this whole topic.
| Model | How CSRA Is Set | Who Uses It |
|---|---|---|
| 50% (half-loaf) states | Community spouse keeps half of countable assets, bounded by federal floor and ceiling. | Most states default here. |
| 100% (maximum) states | Community spouse keeps all countable assets up to the federal ceiling. | A subset of states; verify with your state Medicaid agency. |
| Floor | Federal minimum a community spouse can keep, even if half the couple's assets is less. | All states. |
| Ceiling | Federal maximum a community spouse can keep without a fair-hearing increase. | All states. |
The federal floor and ceiling are adjusted by CMS each January based on the consumer price index. For 2026, both numbers stepped up — but the exact figures should be confirmed with your state Medicaid agency or a state elder-law resource before you act on them.
The Snapshot Date — Why Timing Matters
The CSRA is calculated from a single moment in time called the snapshot date. That date is generally the first day of the first continuous period of institutionalization of 30 days or more.
Everything the couple owns that is countable on that date — checking, savings, brokerage, retirement accounts in many states, cash value of life insurance, second vehicles, vacation property — gets totaled. The CSRA is then carved out of that total according to your state's model.
What is the Medicaid snapshot date?
The snapshot date is the first day of the institutionalized spouse's first continuous stay of at least 30 days in a hospital or nursing home. It freezes the couple's countable assets in time for CSRA calculation. Spending or rearranging assets after this date does not change the CSRA — it can only affect the spend-down owed by the institutionalized spouse.
What Counts, What Doesn't
Not every dollar a couple owns is countable. Several major categories are exempt from the CSRA calculation altogether and stay with the community spouse regardless of value.
The Income Side — MMNA
The CSRA protects assets. The MMNA protects monthly income for the community spouse and is calculated separately, with its own federal floor and ceiling that also adjusted for 2026.
If the community spouse's own income falls below the state-set MMNA, the institutionalized spouse can divert part of their monthly income to the community spouse before any of it goes toward the nursing-home bill. The full mechanics — including shelter-allowance add-ons — are in our MMMNA explainer.
What is the MMNA in 2026?
The Minimum Monthly Maintenance Needs Allowance is the floor of monthly income protected for the community spouse. If the at-home spouse's own income is below the state's MMNA figure, income from the institutionalized spouse is diverted to fill the gap before any of that income goes to the nursing home. CMS adjusts the floor and ceiling each year.
Visualizing How A Typical CSRA Splits
The chart below illustrates the conceptual split between protected and spend-down assets in a 50% state where the couple's countable assets fall between the federal floor and ceiling. Actual splits depend on your state's model and the specific snapshot total.
Increasing The CSRA Above The Standard Amount
Two paths can raise the CSRA above the standard state calculation, and neither requires hiring an attorney to invoke — though both are easier with one.
The first is a fair hearing. If the community spouse can demonstrate that the standard CSRA does not generate enough income to reach the MMNA, a hearing officer can order a higher CSRA so that the protected assets, when invested in safe instruments, produce sufficient income.
The second is a court order for support. A state court can issue a spousal-support order that effectively raises the protected resource and income amounts. States vary in how they treat such orders, and Medicaid agencies do not always follow them automatically.
Common Mistakes Families Make
The CSRA is straightforward in concept and treacherous in practice. A handful of mistakes appear over and over in denials and reduced awards.
What To Do When A Spouse Is About To Enter A Nursing Home
Time is usually short, and the actions that matter are unglamorous. Here is the working sequence most elder-law practitioners follow.
Does the community spouse have to spend down their CSRA?
No. Once the CSRA is calculated and the assets are properly allocated, the community spouse's protected portion belongs to them and is not retested at renewal. Only the institutionalized spouse's continuing eligibility is reviewed. The community spouse can spend, save, or invest those assets as they choose.
Can the community spouse keep the house?
Generally yes, while they live in it. The primary residence is exempt from the CSRA calculation for as long as the community spouse occupies it, subject to a federal home-equity cap that varies by state. Estate recovery after both spouses pass is a separate question handled under different rules.
Does the CSRA apply to unmarried partners?
No. Spousal-impoverishment protections — including the CSRA and MMNA — apply only to legally married couples recognized by the state. Long-term partners, civil-union members in non-recognizing states, and other unmarried households do not have access to these protections and face the standard individual Medicaid asset and income limits.
What The 2026 Adjustment Actually Changes
CMS publishes the federal floor, ceiling, and MMNA figures each year based on the consumer price index. The 2026 figures rose modestly from 2025, in line with general inflation.
For couples currently in the planning window, the practical effect is small but real: a few thousand dollars of additional protected assets at the ceiling, and a slightly higher monthly income floor. For families crossing the snapshot date in 2026, the higher numbers apply automatically — there is nothing to claim or invoke. The state Medicaid agency uses the figures in effect on the snapshot date.
For couples who took a snapshot in 2025 or earlier, the older numbers govern that case. The CSRA is not retroactively recalculated when CMS publishes new figures.
Frequently Asked Questions
Is the CSRA the same in every state?
No. Every state operates within the federal floor and ceiling published annually by CMS, but states choose between the 50% (half-loaf) model and the 100% (maximum) model, and they vary on how they treat retirement accounts, the home-equity cap, and certain other categories. Two couples with identical assets in different states can end up with materially different protected amounts. Always verify the model and current-year figures with your state Medicaid agency or a state elder-law resource before relying on any number.
What happens if our countable assets are below the federal floor?
If the couple's total countable assets on the snapshot date are below the federal CSRA floor, the community spouse keeps all of the countable assets, and there is no spend-down owed by the institutionalized spouse from those resources. The institutionalized spouse still has to meet their own individual asset limit, which is generally a small amount that varies by state. Income rules and the MMNA still apply separately.
Can we move assets into the community spouse's name to protect them?
Transfers between spouses are unlimited and do not trigger a Medicaid transfer penalty, but the snapshot is taken from combined countable assets regardless of whose name is on which account. Retitling does not increase the CSRA. What it can do is simplify post-eligibility administration and, in some states, change how retirement accounts are counted. Reorganization between spouses is fine; gifting to anyone else within the lookback is where penalties begin.
Does the CSRA protect the community spouse from estate recovery?
The CSRA and estate recovery are separate mechanisms. The CSRA protects the community spouse during life; estate recovery is the state's claim against the estate of the deceased Medicaid recipient. States vary widely in how aggressively they recover and what assets they reach. The community spouse's protected resources are generally not subject to recovery while the community spouse is alive, but the rules after both spouses pass are state-specific and worth reviewing before any death of either spouse.
Do we need an elder-law attorney to claim the CSRA?
No. The CSRA is a statutory protection that applies automatically once the application is filed and the snapshot is calculated. You do not need an attorney to invoke it. An elder-law attorney becomes valuable when the standard CSRA does not produce enough income for the community spouse, when retirement-account treatment is contested, when a fair hearing is needed to raise the CSRA, or when the lookback period contains transfers that need to be characterized correctly. For straightforward cases at or under the federal floor, the state Medicaid worker handles the calculation.
Bottom Line
The CSRA is one of the few places in long-term-care planning where federal law actively protects a family's balance sheet rather than restricting it. Used correctly, it preserves a working amount of assets and income for the spouse who stays at home — and it does so without litigation, trusts, or complex maneuvers.
Used incorrectly, or invoked too late, it can leave money on the table the family did not have to lose. Confirm your state's model, lock down your snapshot-date documentation, and verify the 2026 figures with your state Medicaid agency before any irreversible move.
This article is for informational purposes and is not financial, tax, legal, or medical advice. Consult a licensed professional — a state elder-law attorney, a CPA, or your state Medicaid office — before acting on any specific number or strategy. Federal floor, ceiling, and MMNA figures are adjusted annually and vary in application by state.