2026 Medicaid Long-Term Care Benefits When You Are Married

Takeaways

• Medicaid provides a safety net for long-term care, but requires strict limits on income and assets.
• To prevent impoverishment of the healthy spouse (the “community spouse”), Medicaid allows them to keep a Community Spouse Resource Allowance (CSRA) of assets, ranging from $32,532 to $162,660 for 2026.
• The healthy spouse is also allowed a Monthly Maintenance Needs Allowance (MMMNA) for income, which for 2026 is between $2,643.75 and $4,066.50 (with higher minimums in Alaska and Hawaii).

Most Americans aged 65 and older will need some form of long-term care in their later years. The cost of such care has been steadily increasing. In 2024, the average monthly cost for a semi-private room in a nursing home was $9,277. Thankfully, Medicaid provides a safety net for millions of older adults who need long-term care services.

Income Requirements for Medicaid

Medicaid is a joint federal and state program that offers health care coverage to Americans who have limited income and relatively few assets. The asset and income limits are quite strict. In most states, an individual cannot have more than $2,000 in countable assets to qualify for Medicaid benefits.

You may be wondering how these limits affect a married couple if one of them needs long-term care but the other doesn’t. Would the healthy spouse have to live in poverty? Fortunately, the Medicaid program permits the healthy spouses of Medicaid beneficiaries to retain limited resources to keep them from becoming impoverished.

Community Spouse Resource Allowance for 2026

Each year, the Centers for Medicare & Medicaid Services (CMS) issues updated Community Spouse Resource Allowance (CSRA) figures. The CSRA outlines how much of the couple’s assets the healthy spouse can keep while their partner gets their long-term care covered by Medicaid. The CSRA generally increases each year.

Starting in January 2026, a spouse who continues to live at home while their partner receives Medicaid long-term care benefits can retain up to $162,660 in assets, an increase from $157,920 in 2025. The minimum CSRA for 2026 will be $32,532. State Medicaid programs can set their limits within this range.

Monthly Maintenance Needs Allowance for 2026

If a spouse receives long-term care benefits through Medicaid while their partner continues to reside at home, the partner at home is also allowed to receive a limited income each month. Medicaid calls this the minimum monthly maintenance needs allowance (MMMNA), and for 2026 the amount will be between $2,643.75 and $4,066.50. The maximum MMNA for 2025 was $3,948. Note that Alaska and Hawaii’s minimums are both higher than the standard minimums for the other 48 states.

Why This Update Matters

The rising costs of long-term care, such as nursing homes, assisted living, and in-home services, can quickly drain a couple’s savings. Without protections like the CSRA and MMNA, the healthy spouse remaining at home could be faced with severe financial hardship. By updating these federal allowances each year, CMS helps ensure that Medicaid’s long-term care eligibility rules remain sensitive to inflation and cost-of-living pressures.

For many older married couples, these 2026 figures represent a noticeable increase in the amount of assets and income they can preserve — offering a stronger financial safety net for the spouse who doesn’t need Medicaid benefits.

Additional Reading

For additional reading on topics related to Medicaid, check out the following articles:

• Promissory Notes and Medicaid Planning
• The Role of an Elder Law Attorney in Medicaid Planning
• What Are Medicaid Asset Protection Trusts?
• What to Do If You Lose Your Medicaid Coverage