MassHealth Treatment of Income

When a nursing home resident becomes eligible for MassHealth, all of his or her income, less certain deductions, is paid to the nursing home. There is a small personal needs allowance (currently $72.80) and a deduction for any uncovered medical costs (including medical insurance premiums). As you will see below, the situation is different if the nursing home resident is married with a spouse still living at home.

Your Spouse: Income Protection for Married Couples
The situation is more favorable if you are married. A married applicant, whose spouse continues to live in their home may have an exempt portion of their income paid to their spouse. In this situation, the spouse who continues to live at home is called the “community spouse.” The community spouse is permitted to accept income each month, called the “Monthly Maintenance Needs Allowance” (MMNA). The MMNA is between $1,991.25 and $2,980.50 per month (depending on whether a hardship can be demonstrated).

An example will help explain how this works. Let’s say Harry and Wendy are married senior citizens, and Wendy has to move into a nursing home. And let’s assume Wendy and Harry are collecting the following in Social Security income: Harry gets $1,400 each month, and Wendy gets $1,600 each month. Wendy’s $1,600 Social Security check would get distributed as follows:

  Single Married
Social Security Income
$1,600 $1,600
Wendy Keeps ($72.80) (72.80)
Harry Gets (MMNA) N/A ($1,527.20)
Nursing Home Gets ($1,527.20) ($0.00)

Keep in mind that there is no limit on the spouse’s income, nor is there any obligation that they will contribute any income to the nursing home spouse’s cost of care. There are other potentially applicable exemptions (e.g., for business property) that, depending up on your individual circumstances, may be worth discussing with counsel.