Community Spouse Resource Allowance: What It Is and How It Works

If your husband or wife is moving into a nursing home and applying for Medicaid, the community spouse resource allowance (CSRA) is the amount by which a protected figure set under federal law exceeds the resources the spouse at home already has. The protected figure is the greatest of a federal minimum (or a higher amount in the state plan, up to the federal maximum), the lesser of half the couple's resources and the federal maximum, an amount set at a fair hearing, or an amount from a court order, and resources above it count toward the other spouse's eligibility.

Most people facing this question are a husband or wife who has just watched a spouse leave home for care, or an adult child sitting with a parent at the kitchen table, bank statements spread out, trying to work out whether the parent at home will be left with enough to live on. The fear behind the search is concrete: that the nursing home bill, or the Medicaid application, will take everything the couple saved over a lifetime.

This page explains the federal rules that set what the spouse at home keeps, how a state's own Medicaid program shapes the figure, and where the look-back, transfer penalties and estate recovery fit in. It is written for families facing long-term-care costs and the asset decisions that come with them.

What the Community Spouse Resource Allowance Is

The community spouse is the husband or wife of an institutionalized spouse, meaning one who is in a medical institution or nursing facility and is likely to remain there for at least 30 consecutive days (42 U.S.C. § 1396r-5(h)). Medicaid.gov's eligibility policy page also describes these protections as covering the spouse of someone who needs long-term services and supports in a home or other community-based setting. A countable asset is property Medicaid counts toward its resource limit; an exempt asset is one it leaves out.

The community spouse resource allowance, often shortened to CSRA, is the amount by which a protected figure exceeds the resources otherwise available to the community spouse. It comes from the federal spousal-impoverishment statute, 42 U.S.C. § 1396r-5(f)(2).

Medicaid.gov's spousal impoverishment page explains why Congress acted in 1988: without these provisions, the spouse still living at home could be left "with little or no income or resources." Under the statute, a set amount of the couple's resources is protected for that spouse, and in some cases a share of the institutionalized spouse's income is too.

This page covers Medicaid long-term care only. It does not cover Medicare, private long-term-care insurance or veterans' benefits.

How the Federal Floor and Ceiling Work

Under 42 U.S.C. § 1396r-5(c)(1), the state computes the total value of resources in which either spouse has an ownership interest, and a "spousal share" equal to one-half of that total. That value is taken as of the beginning of the institutionalized spouse's first continuous period of institutionalization. Families often call this the snapshot.

The statute then takes the greatest of four amounts: a floor of $12,000 (indexed for inflation), or a higher figure the state chooses in its plan, up to the ceiling; the lesser of the spousal share or $60,000 (indexed); an amount set at a fair hearing; or an amount transferred under a court order. The CSRA is the amount, if any, by which that figure exceeds the resources otherwise available to the community spouse.

In practice, if half the combined resources falls below the floor, the protected figure is the floor amount. If half is above the ceiling, the protected figure is the ceiling, unless a hearing or court order sets more. A state that specifies a floor equal to the ceiling makes the protected figure the federal maximum in every case.

The dollar figures are adjusted each January 1. The CMS 2026 standards bulletin lists a minimum resource standard of $32,532 and a maximum of $162,660, effective January 1, 2026.

Either spouse may ask the state to assess and document the couple's total resources at the snapshot. If that request is not part of a Medicaid application, the state may charge a fee no greater than its reasonable expenses, and it must give notice of the right to a fair hearing.

What Counts — and What Does Not — as a Countable Asset

Countable assets generally include checking and savings accounts, certificates of deposit, cash, brokerage and investment accounts, and most other property that can be turned into cash. Under 42 U.S.C. § 1396r-5(c)(2), at the time of application all resources held by either spouse, or both, are treated as available to the institutionalized spouse, regardless of state community-property or marital-property laws, to the extent they exceed the protected figure computed under § 1396r-5(f)(2)(A). Which spouse's name is on an account does not change the count.

Under 42 U.S.C. § 1396r-5(c)(5), resources excluded under the federal Supplemental Security Income rules are left out of the count, including the home, household goods, personal effects, an automobile and burial spaces, and the list is partial. What a state exempts, and on what conditions, can also depend on that state's current rules.

The home carries a federal limit. Under 42 U.S.C. § 1396p(f), Medicaid long-term-care coverage is barred when home equity exceeds a set limit, unless a spouse, a child under 21 or a blind or disabled child lives in the home. The CMS bulletin lists home-equity limits for 2026 of $752,000 minimum and $1,130,000 maximum; each state's figure falls within that range.

Retirement accounts are where many families' questions start. Whether an IRA or 401(k) counts, and how, depends on that state's current rules. California's approach is set out on this site's page on Medi-Cal asset limits.

How States Set Their Own CSRA Figures

Each state runs its own Medicaid program inside the federal framework. Under 42 U.S.C. § 1396r-5(f)(2)(A)(i), a state may specify in its state plan a minimum amount higher than the federal minimum, up to the federal maximum.

Where a state specifies no higher amount, the one-half calculation described above applies between the federal minimum and maximum, so the protected figure depends on the couple's snapshot total. A state that specifies the federal maximum makes that the protected figure in every case. Which choice a particular state has made is in that state's own rules.

A state's current figure is published by its Medicaid agency and changes when the state updates its rules or the federal figures adjust each January. A figure from another state, or from an earlier year, can mislead.

This page describes the federal framework. The exact allowance in a particular state depends on that state's current rules. For one state's long-term-care picture, see this site's page on Florida Medicaid planning.

The Monthly Maintenance Needs Allowance and Income Rules

Assets are one question; the monthly check is another. The minimum monthly maintenance needs allowance, or MMMNA, is a monthly income level that the community spouse's income can be raised to, not a limit on what that spouse may keep. Each state sets it under 42 U.S.C. § 1396r-5(d)(3), at no less than 150 percent of one-twelfth of the federal poverty line for a two-person household plus an excess shelter allowance, and no more than an indexed cap, unless a fair hearing raises it (§ 1396r-5(e)(2)(B)).

If the community spouse's own income falls short of the MMMNA, a community spouse monthly income allowance can be deducted from the institutionalized spouse's income to make up the difference, but only to the extent that income is actually made available to the community spouse. The statute also lists, in order, a personal needs allowance, a family allowance for certain dependents living with the community spouse, and incurred medical expenses.

According to the CMS bulletin, the minimum MMMNA is $2,705 in all states except Alaska and Hawaii, effective July 1, 2026, and the maximum is $4,066.50, effective January 1, 2026. The minimum changes each July 1 and the maximum each January 1; a state's own figure applies from the date that state gives.

The CSRA governs assets kept at application. The MMMNA governs ongoing monthly income. Federal law provides for a fair hearing, and court-ordered support, as routes to a different amount, discussed below.

Transfers, the Look-Back Period, and the Community Spouse

The look-back period is the window before a Medicaid application in which the agency reviews transfers made for less than fair market value. Under 42 U.S.C. § 1396p(c)(1)(B)(i), the federal look-back is 60 months for transfers made on or after February 8, 2006. Medicaid.gov describes this as the "five-year period preceding their Medicaid application." A state's own look-back depends on its current rules.

A penalty period is a stretch of Medicaid ineligibility for long-term care caused by a disqualifying transfer. Under 42 U.S.C. § 1396p(c)(1)(D)(ii), it begins on the first day of a month during or after which assets were transferred or the date the person is eligible and would otherwise be receiving institutional-level care based on an approved application, whichever is later, and which does not fall within another period of ineligibility. A gift made early in the look-back is penalized the same way as a recent one. The length equals the uncompensated value transferred divided by the average monthly cost to a private patient of nursing facility services in the state (or, at the state's option, in the community where the person is institutionalized) at the time of application, and states may not round down fractional periods.

Not every transfer is penalized. The statute's exceptions include transfers to the person's spouse, which carry no transfer penalty under 42 U.S.C. § 1396p(c)(2)(B)(i), and a home transferred to a spouse. Separately, 42 U.S.C. § 1396r-5(f) lets the institutionalized spouse transfer the CSRA to the community spouse, as soon as practicable after eligibility is first determined.

Resources above the protected figure are treated as available to the institutionalized spouse, so they count against the state's resource limit. Every asset and transfer must be reported accurately. More on this appears on the pages on Medicaid spend-down and Medicaid crisis planning.

Estate Recovery and the Community Spouse

Estate recovery is the process by which a state seeks repayment from a deceased Medicaid recipient's estate for long-term-care benefits it paid. It is governed by 42 U.S.C. § 1396p(b). Medicaid.gov's eligibility policy page states that state programs must recover the cost of certain benefits, including nursing facility services, home and community-based services, and related hospital and prescription drug services. The statute states this requirement for individuals who were 55 years of age or older when they received the benefits, among others (42 U.S.C. § 1396p(b)(1)).

Federal law delays recovery, but does not cancel it, while a surviving spouse, a child under 21 or a blind or disabled child survives, under 42 U.S.C. § 1396p(b)(2). So the home a community spouse lives in is generally not reached while that spouse is alive. After both spouses have died, the state may seek recovery, and what it can recover from depends on that state's rules.

Medicaid's eligibility rules decide which resources count toward coverage, and estate recovery is a separate process after death. Medicare and private insurance are not covered here.

When the Standard CSRA May Not Be Enough

For a spouse at home whose own income is small, the standard figure can feel thin against rent, utilities and daily costs. The statute provides a route for that. Under 42 U.S.C. § 1396r-5(e)(2)(C), if either spouse establishes that the CSRA, in relation to the income it generates, is inadequate to raise the community spouse's income to the MMMNA, an amount adequate to provide the MMMNA is substituted. The state first counts the institutionalized spouse's income that could be made available to the community spouse (§ 1396r-5(d)(6)), and it must give notice of the hearing right when it provides a resource assessment. The hearing is available once an application has been made for the institutionalized spouse, and a hearing on the resource allowance must be held within 30 days of the request (§ 1396r-5(e)(2)(A)).

A court may also enter a support order against the institutionalized spouse. Under 42 U.S.C. § 1396r-5(f)(3), transfers made under such an order for the support of the community spouse or certain family members are not subject to the transfer rules of 42 U.S.C. § 1396p, and the CSRA can be the amount transferred under the order. Whether a hearing officer or a court sets a higher amount depends on the facts and the law that applies.

More on the role of an attorney in Medicaid planning appears on the page about a Medicaid planning attorney.

Requesting a Consultation

The resource allowance turns on the date the snapshot is taken, how each account is titled, whether a retirement account or the home counts in that state, and which transfers fall inside the look-back. This page does not cover Medicare, private long-term-care insurance or veterans' benefits.

You can request a consultation about your family's Medicaid and long-term-care options through Medicaid Asset Protection Group.