MA No Comments

Get Up To Date With New 2019 Medicaid Numbers

The Centers for Medicare and Medicaid Services (CMS) have issued new annual spousal impoverishment figures for 2019.  You can download a complimentary FREE 2019 Medicaid Planning Desk Reference.   The full numbers are contained in the Desk Reference, which you can download for free by clicking the link at the bottom of this article.

Here is a quick recap of the new figures and what they mean:


The New minimum Community Spousal Resource Allowance (CSRA) is $25,284. The new maximum CSRA is $126,420.

To get your FREE 2019 Medicaid Planning Desk Reference, click here.

Reminder, in the straight deduction states like Florida and California the Max CSRA is the pure asset cap.  Any asset amount below that is sufficient to qualify for long-term care Medicaid.  For example, if a couple has $100,000 in countable assets, then in the straight deduction states they do not need to spend down any further.  Also, in straight deduction states the minimum CSRA is never a factor in planning.

In the one-half deduction states like Michigan, Pennsylvania, Kansas and Ohio, the minimum and maximums CSRA limits are both used.  For example, take the couple with the $100,000 in resources on the “snapshot” date (i.e., the date of admission to the nursing home or the hospital when the state requires a valuation of all assets available by the couple for the spenddown).  In a one-half deduction state, the CSRA calculation would assess one-half of the total countable resources as the CSRA.  Take total countable resources of $100,000 and divide by 2 to yield the CSRA of $50,000.

Where the maximum is used in a one-half deduction state is when the countable resources exceed twice the maximum.  For instance, a couple with $300,000 would only be able to set aside $126,420 for the CSRA.  The remaining assets would be exposed to the Medicaid spenddown.

The minimum CSRA is a floor and only factors in when one-half of the total amount of countable assets falls below the minimum threshold.  For example, if a couple has $40,000, then the CSRA would not be $20,000 because that’s below the minimum.  The CSRA in that case would default to the new minimum $25,284.

Also note: In most states the new CSRA limits apply to snapshot dates in 2019 only. Typically, if an applicant’s snapshot date is 2018 but they apply in 2019, the CSRA amount will be based on the CSRA for snapshot date in 2018 and not the application date of 2019.  If you are looking for a prior year’s CSRA limits, please contact our office and we can help you locate the appropriate and applicable CSRA limit.


The Minimum Monthly Maintenance Needs Allowance (MMMNA) is $2,057.50 (for all states except Alaska and Hawaii).  The new maximum amount is $3,160.50.  These allowance limits are set mid-year and these numbers remain in effect until July 1, 2019.  This figure is used as part of a formula to determine how much of the patient’s income a community spouse can keep to live on.

The new Community Spouse Monthly Housing Allowance is $617.25 (for all states except Alaska and Hawaii).  This figure factors into the spousal allowance formula to determine if excess shelter expenses can be used to boost the MMMNA.   For example, if the community spouse has a large rent or mortgage payment or is in independent or assisted living, the excess costs for shelter can allow the community spouse to keep more of the institutional spouse’s income to help cover the expenses.  Like the MMMNA, this number also changes mid-year and remains in effect until July 1, 2019.


The new minimum Home Equity Limit is $585,000.00.  In the handful of states that have adopted an upper limit, that amount is $878,000.00 for 2019.  NOTE: This limit does not apply if the patient is married; but if the community spouse dies and the home automatically becomes owned by the patient spouse as a result of joint ownership on the deed, it could cause the patient to become ineligible for Medicaid.


If you want more information on how to calculate the CSRA or how to maximize the conversion of excess assets to income you should consider purchasing the Medicaid Planning Guidebook or taking the Medicaid Planning Course. We provide a full range of support for advisors of all varieties to assist with their Medicaid Planning cases, including advisor mentoring and case design services.  We also have live training courses coming up that will enable you to add long-term care Medicaid Planning to your practice.  Make 2019 a more profitable year by helping your clients long-term care Medicaid eligibility and asset protection – we’ll show you the way!


To get your FREE 2019 Medicaid Planning Desk Reference, click here.