Spousal Impoverishment Protection Georgia Medicaid: CSRA and MMMNA Rules for 2026

The Problem Spousal Protections Solve

When one spouse enters a Georgia nursing home and applies for Medicaid, the individual asset limit is $2,000. Without spousal protections, a married couple would have to spend down virtually everything — including the stay-at-home spouse's savings, retirement accounts, and potentially the family home — before the nursing-home spouse could qualify. Federal spousal impoverishment rules prevent this by carving out specific asset and income protections for the "community spouse" (the one who stays home).

The Community Spouse Resource Allowance (CSRA) in 2026

The CSRA determines how much of the couple's combined countable assets the community spouse can keep. Georgia follows federal rules:

Minimum CSRA: $32,532 Maximum CSRA: $162,660

Here's how the calculation works. On the day the nursing-home spouse enters a facility (or the first day of a continuous period of institutionalization), DFCS takes a snapshot of the couple's total combined countable assets. The community spouse keeps the greater of $32,532 or one-half of the combined assets, up to the $162,660 cap.

Example: A couple has $240,000 in combined countable assets. Half is $120,000. Since $120,000 falls between the minimum and maximum, the community spouse keeps $120,000. The nursing-home spouse must spend down their remaining share to $2,000.

Example 2: A couple has $400,000 in combined assets. Half is $200,000 — but the maximum CSRA is $162,660. The community spouse keeps $162,660 and the remaining $237,340 must be spent down to $2,000.

Example 3: A couple has $50,000 total. Half is $25,000 — below the minimum floor. The community spouse keeps $32,532, and the nursing-home spouse retains $17,468, which must be spent down to $2,000.

The "Name on the Check" Rule

Georgia uses the "Name on the Check" rule for income. Only income paid directly to the applicant counts toward their Medicaid eligibility. The community spouse's Social Security, pension, and other income paid in their name is entirely excluded from the applicant's income calculation.

This means a community spouse receiving $3,500 per month in their own Social Security and pension faces no income reduction from the nursing-home spouse's Medicaid application. Their income is theirs.

MMMNA: Protecting the Community Spouse's Monthly Income

If the community spouse's own income is insufficient to maintain a basic standard of living, they can claim a portion of the nursing-home spouse's income. This is the Minimum Monthly Maintenance Needs Allowance (MMMNA).

2026 MMMNA floor: $2,705.00 per month 2026 MMMNA ceiling: $4,066.50 per month

The floor resets annually on July 1st. The ceiling resets on January 1st.

How it works: If the community spouse's personal income is $1,800 per month (from their own Social Security), they have a shortfall of $905 below the $2,705 floor. The nursing-home spouse can divert $905 per month from their income — typically through the Qualified Income Trust — to the community spouse. This diverted amount is deducted before calculating the nursing-home resident's patient liability.

The MMMNA can exceed the floor in cases where the community spouse has documented excess shelter costs. The applicable calculation can increase the allowance up to the $4,066.50 ceiling. Some families with high housing costs in metro Atlanta qualify for this excess shelter adjustment.

The Home and Vehicle

The primary home is exempt from the asset calculation as long as the community spouse lives there — no equity limit applies when a spouse occupies the home. The $752,000 equity cap only matters when no spouse (or other qualifying person) resides in the home. One vehicle is also exempt regardless of value.

Strategies That Maximize Spousal Protection

File the asset snapshot early. The snapshot date is crucial — it determines the CSRA calculation. If you know a nursing home admission is coming, understand that assets held on the day of admission set the denominator. Spending down before admission (on exempt items like home repairs, prepaid burial plans, or paying off the mortgage) reduces countable assets and can ensure the community spouse keeps a larger percentage of what remains.

Request an administrative MMMNA hearing. If the community spouse's documented living expenses exceed the standard MMMNA, Georgia allows a request for an increased allowance through an administrative hearing. This requires detailed documentation of shelter costs, medical expenses, and other necessary expenditures. The hearing can raise the MMMNA above the standard calculation, up to the ceiling.

Coordinate with the QIT. When the nursing-home spouse has income above $2,982 and a Miller Trust is in play, the MMMNA diversion flows through the trust. The trustee's monthly disbursement sequence must account for the spousal allowance: income enters the QIT, the spousal allowance is paid out to the community spouse, and the remaining balance goes to the nursing facility. Getting this sequence wrong — or omitting the spousal payment — can result in both an underpaid facility and an impoverished community spouse.

The Georgia Hospital-to-Home Transition Guide includes the spousal protection worksheet that walks couples through the CSRA calculation, the MMMNA shortfall analysis, and the monthly QIT disbursement sequence — ensuring the community spouse retains maximum assets and income while the nursing-home spouse maintains Medicaid eligibility.

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