Paying for care

Medicaid Personal Needs Allowance by State (2026)

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By Nursing Home Checker · Updated Oct 12, 2026 · How guides are checked · Share

What is the Medicaid personal needs allowance?

It is the amount of monthly income a nursing home resident on Medicaid is allowed to keep for personal use. Federal rules describe it as an allowance "reasonable in amount for clothing and other personal needs of the individual while in the institution."

When Medicaid pays for a nursing home, the state counts the resident's total income. It first sets aside the personal needs allowance. It then sets aside other amounts the rules allow, such as income for a spouse or family at home and health insurance premiums. Federal rules (42 CFR 435.725) then require the state to reduce its payment to the home by the amount of the resident's income left after the allowance and these other deductions. For how this works with Social Security, see can a nursing home take your Social Security check.

What is the federal minimum personal needs allowance?

The federal minimum is $30 a month for an individual and $60 a month for a couple. The couple amount applies when both spouses are aged, blind or disabled and their incomes are counted as available to each other. These figures come from federal law (42 U.S.C. 1396a(q)) and the matching Medicaid rule (42 CFR 435.725).

Federal law says the allowance must be "not less (and may be greater) than" this minimum. So every state can choose a higher amount, and most of the states in the table below do. The $30 floor is not tied to inflation in federal law. The federal rule that sets it was last amended in 1993.

Personal needs allowance by state

This table shows each state's rule in the words of its own source. Select a state to see its other nursing home rules and contacts.

Each state's figure was checked against the state source on the date shown on its state page. The table lists the states this site covers.

Why might your state's amount be different from the table?

Some states change the amount every year, so a figure can go out of date between checks. Several states tie the allowance to the Social Security cost-of-living adjustment and change it each January 1. Others adjust it each July 1. Some set it in a yearly budget, so it can change when a new budget passes.

• Changes each January: Arizona, Colorado, the District of Columbia, Minnesota, New Hampshire, Oregon and Washington list 2026 amounts that are expected to change on January 1, 2027.
• Changes each July: Maryland, New Mexico and North Dakota adjust in July. The table shows their July 1, 2025 amounts because a July 2026 amount had not been confirmed in an official source when they were checked; North Dakota had announced a $3 increase effective July 1, 2026.
• Other states to recheck: Nevada's State Plan says its amount is adjusted each year, but no newer figure had been found when it was checked. Kentucky's increase to $60 came through its 2024-2026 budget, and New Jersey sets its amount through its yearly appropriations act, so either could change with a new budget. Bills to raise the allowance were pending in Ohio, Michigan and New Jersey but had not passed when checked.

In the other states, the amount changes only when the state changes its law, rule, plan or budget. Some have kept the same amount for many years, such as Indiana ($52 since July 1, 2002) and Massachusetts ($72.80 since 2007), while others raised it between 2023 and 2025. Your state Medicaid agency can confirm the current figure. Its contact details are on your state's page and in the guide to how Medicaid pays for a nursing home.

Does a veteran on Medicaid in a nursing home keep a $90 VA pension?

Federal law limits the VA pension to $90 a month for a veteran with no spouse or child who is covered by Medicaid in a nursing facility (other than a state veterans home that receives VA per diem payments). The limit starts after the month of admission. It also applies to a surviving spouse with no child, and to certain children who receive a pension. The law says the Medicaid payment to the nursing facility may not be reduced by that $90.

The federal law caps the pension. It does not itself set the state's personal needs allowance, and states handle the $90 in different ways. The table shows each state's own rule where its source covers veterans. For more on VA benefits and nursing homes, see does the VA pay for nursing home care.

What can a nursing home charge to a resident's personal funds?

A nursing home may not charge a resident's personal funds for any item or service that Medicare or Medicaid pays for, except applicable deductibles and coinsurance. Federal rules say that during a covered Medicare or Medicaid stay this includes:

• nursing services, food and nutrition services, and the activities program;
• room and bed maintenance services;
• routine personal hygiene items and services, such as hair hygiene supplies, a comb and brush, bath soap, a toothbrush and toothpaste, deodorant, incontinence care and supplies, and over-the-counter drugs;
• medically related social services;
• basic personal laundry.

A home may charge a resident's funds for an item or service only if the resident asks for it, it is not needed for the care plan, Medicare or Medicaid does not pay for it, and the home says there will be a charge and what it will be. The home must say so both orally and in writing. It may not require a request as a condition of admission or of staying. Examples in the rule include a telephone, television or personal computer, personal clothing, reading matter, gifts, flowers, social events and entertainment outside the home's activities program, a privately hired nurse or aide, a private room that is not needed for therapy, and specially requested food. The home may not charge for special foods or supplements ordered by the resident's doctor or another listed practitioner.

What are the rules when the nursing home holds a resident's money?

A home may hold a resident's money only if the resident chooses to deposit it there, in writing. Residents have the right to manage their own financial affairs. The home may not require them to deposit funds with it. When it does hold funds, federal rules say it must act as a fiduciary and:

• keep funds over $100 in an interest-bearing account separate from the home's own accounts, and credit all interest to the resident. For a resident whose care is paid by Medicaid, the threshold is $50;
• keep a full, separate accounting for each resident and never mix resident funds with facility funds;
• give the resident a statement every quarter and whenever the resident asks;
• tell a Medicaid resident when the account reaches $200 less than the SSI resource limit for one person. That limit is $2,000 under federal law, so the notice comes at $1,800. The notice must explain that the resident may lose Medicaid or SSI if the account plus other countable resources reaches the limit;
• carry a surety bond, or other assurance the federal government accepts, covering all resident funds it holds. CMS guidance says self-insurance and bank deposit insurance are not acceptable substitutes;
• within 30 days after discharge, eviction or death, give the funds and a final accounting to the resident or, after death, to the individual or probate jurisdiction handling the estate, following state law.

The $1,800 notice is tied to the federal SSI figure. A state's own Medicaid resource limit for nursing home care may be different.

Where can you check the amount or ask about a charge?

• Your state Medicaid agency, for the current personal needs allowance and how it applies to a resident's income.
• The home's business office, for the quarterly statement of a resident's account and a written list of charges.
• Your state's long-term care ombudsman, for questions about charges or resident funds. See how to reach the ombudsman or file a complaint.

To look at a specific home's inspections, including any citations, search by name, city or ZIP code on the nursing home search page. For state and national figures, see the nursing home data reports.