What is the “Minimum Monthly Maintenance Needs Allowance” (MMMNA) in 2017 for Alabama Medicaid long term care in a nursing home
As a general rule, all but $30 of the income of the person going into the nursing home must be spent on the nursing home. But as you will see below, sometimes we can take (divert) some of the income from the “institutional spouse” and give that to the spouse still at home. This relates to the “Minimum Monthly Maintenance Needs Allowance” (MMMNA) under Alabama Medicaid. It’s a mouthful but it is very helpful to families.
Let’s take a look at this concept….
“Can you give me a quick example of a couple to go through this MMMNA concept?”
Let’s say we are dealing with Ken and Jill who are married and Ken is going into the nursing home. So Ken will be the “institutional spouse”.
Jill, who is staying home, will be the “community spouse” as she is staying in the community.
Ken makes $2,800 a month. (Keep in mind Ken’s income is actually too high so we have to fix this to qualify under Alabama Medicaid).
Jill makes $1,100 a month.
So if we ignore (for a moment) the MMMNA, Ken pays $2,770 a month towards his nursing home bill and he keeps $30 (personal needs allowance).
“What about the income of the spouse staying at home?”
Jill keeps her money — her $1,100.
“What if the spouse at home doesn’t make enough?”
So the problem is Jill was in a house with a total of $3,900 in income every month (Ken $2,800 and Jill $1,100) and now she is only getting $1,100.
So the Federal law — and Alabama Medicaid — is we have this concept of the minimum amount every month that the community spouse needs to make. That’s our MMMNA (minimum monthly maintenance needs allowance).
“What is the number for 2017 on the MMMNA?”
It is $2,002 for 2017 under Alabama Medicaid.
We always look to see if the community spouse makes this much or less than this every month.
“So how does the MMMNA work for Jill?”
Since Jill only makes $1,100, her income is below the $2,002.
So we take or divert money from Ken’s income to get Jill up to $2,002.
We need $902 to get her up to $2,002.
So here’s the bottom line (and understand there are exceptions and details — this is a high level overview):
Ken who makes $2,800 keeps $30 for his personal needs allowance. That leaves him with $2,770. But we divert $902 to Jill. So Ken pays to the nursing home $1,868. Alabama Medicaid pays the rest to the nursing home.
Jill keeps her entire income of $1,100 plus she gets the $902 from Ken for her MMNA so that gets her to the minimum amount of $2,002.
“Doesn’t this violate the law to use the MMMNA?”
No — this is the law. The MMMNA comes from Alabama Medicaid and the federal law of Medicaid in general.
So we aren’t doing anything wrong — instead we are following the law.
Here’s the deal — Medicaid is very much a law of rules and numbers. Medicaid does nothing wrong when it enforces the rules. For example, one family I know was turned down for Medicaid because the person in the nursing home ended one month with $1 more than she was allowed to have. So this cost the family about $5,000.
Is that fair? Well it is the rule so we have to deal with it.
Alabama Medicaid is going to follow the rules — when it helps them and when it hurts them. Same with you. And if someone is not following the rules, there are ways to force them (including Medicaid) to follow the rules.
So nothing wrong with using the MMMNA — the law is set up to protect the spouse at home so make sure you look into this.
“What should I do if I have questions about the MMMNA or anything else with Alabama Medicaid?”
Give us a call at 205-879-2447.