Allow a deduction from income to meet a community spouse's needs when the community spouse does not have enough income to meet his or her own needs. Do not allow this deduction from SSI. If the customer has SSI and another income source, only allow a deduction up to the amount of the other income. Do not allow the Community Spouse Maintenance Needs Allowance (CSMNA) for a community month (one in which the applicant was not a resident of the NH or SLF on the first day of the month).
The term "community spouse" means the husband or wife of an NH resident, of an SLF resident or of a customer applying for or receiving DoA HCBS waiver services. A spouse who lives in an SLF or NH is not considered a community spouse but a community spouse may apply for or receive DoA HCBS waiver services as long as he or she does not also receive regular or spenddown medical assistance. The community spouse may receive QMB only, SLIB only or QI-1 only benefits. For persons applying for or receiving DoA HCBS waiver services, the community spouse may be living with or apart from the LTC applicant/customer.
Beginning 01/01/2024, the CSMNA is the maintenance needs standard of $3853.50 minus the community spouse's gross income. This amount applies unless a greater amount is required by a court order or as the result of a fair hearing. The previous amounts can be found at the WAG 25-03-02(2) Medical Standards
This deduction is not mandatory and is only allowed to the extent income is actually contributed to the community spouse.
NOTE: The LTC spouse also gets to keep the appropriate personal needs allowance (PNA) based on facility type. The PNA is deducted first before the CSMNA. Refer to PM 15-06-02-b: NH Personal Needs Allowance/SLP Room and Board Amount.
Deduct the amount established as the CSMNA when determining the amount of countable income to apply to medical care costs.
For a customer applying for or receiving DoA HCBS waiver services, do not allow a deduction for the CSMNA if:
- the customer would be enrolled with a spenddown and countable monthly excess income to apply to medical care costs is greater than $1,800 (after allowing for the CSMNA and/or the Family Maintenance Needs Allowance); or
- the customer would be enrolled with a spenddown and excess nonexempt resources are greater than $17,500 (after allowing the Community Spouse Resource Allowance and the $17,500 resource limit); or
- the customer is subject to a penalty period due to a nonallowable resource transfer.