The Centers for Medicare & Medicaid Services (CMS) has released the 2023 federal guidelines for how much money the spouses of institutionalized MassHealth recipients may keep, as well as related MassHealth figures.

What Are Spousal Impoverishment Rules?
Spousal impoverishment is a concern for older couples when there is one spouse who requires long-term care and applies for MassHealth.
Before the federal government enacted spousal impoverishment protections, many healthy spouses faced poverty when their partners needed long-term care. The spousal impoverishment rules are based on the idea that spouses will provide for each other.
Community Spouse Resource Allowance
In 2023, the spouse of a MassHealth recipient living in a nursing home (called the “community spouse”) may keep as much as $148,620 without jeopardizing the MassHealth eligibility of the spouse who is receiving long-term care.
Known as the community spouse resource allowance (CSRA), this is the most that MassHealth may allow a community spouse to retain without a hearing or a court order.
Monthly Maintenance Needs Allowance
Meanwhile, the maximum monthly maintenance needs allowance (MMMNA) for 2023 will be $3,715.50. This is the most in monthly income that a community spouse is allowed to have if their own income is not enough to live on and they must take some or all of the institutionalized spouse’s income.
The minimum monthly maintenance needs allowance for the lower 48 states will be $2,288.75.
In determining how much income a particular community spouse is allowed to retain, states must abide by this upper and lower range. Bear in mind that these figures apply only if the community spouse needs to take income from the institutionalized spouse.
According to MassHealth, the community spouse may keep all their own income, even if it exceeds the maximum monthly maintenance needs allowance. This is one of the reasons immediate annuity planning should be considered in crisis situations where a 5 year penalty period cannot be triggered.
The new spousal impoverishment numbers (except for the minimum monthly maintenance needs allowance) took effect on January 1, 2023.
Home Equity Limits
In 2023, a MassHealth applicant’s principal residence will not be counted as an asset by MassHealth if the applicant’s equity interest in the home is less than $1,033,000. However, even a non-countable primary residence can be subject to an Estate Recovery Lien in certain circumstances which is why planning with an elder law attorney is critical even when your home equity is less than this number. Contact us today.