Delaware Medicaid Personal Needs Allowance (2026): $75/Month

Delaware sets the Medicaid Personal Needs Allowance at $75 a month, the money a nursing home resident keeps for themselves while nearly all their other income goes toward the cost of care. If someone you love is on Medicaid in a Delaware nursing facility, the Delaware Medicaid Personal Needs Allowance is the one slice of their monthly income the state protects from the bill, for haircuts, clothing, a phone, or a coffee with a visitor.1

In This Guide

• What Is the Delaware Medicaid Personal Needs Allowance?
• The Delaware Medicaid Personal Needs Allowance in 2026 vs the Federal Floor
• How the Money Is Held: The Resident Trust Fund
• Patient Liability: Where the Allowance Fits in the Math
• What the Facility Must Provide and Can't Bill to Your PNA
• How a VA Pension Works Alongside the Allowance
• Frequently Asked Questions
• Learn More

What Is the Delaware Medicaid Personal Needs Allowance?

When someone qualifies for Medicaid to pay for a nursing home, Medicaid doesn't hand them a check for rent. It pays the facility directly, and in return the resident is expected to contribute almost all of their own monthly income, their Social Security, any pension, and so on, toward the cost of their care. That contribution is called the resident's patient liability, and for many residents it takes nearly their entire check.

Federal law doesn't let it take everything. Every state must let an institutionalized resident keep a small monthly amount for personal expenses, the things a facility's room-and-board rate was never meant to cover: a haircut at the salon rather than the in-house barber, a favorite brand of lotion, stamps and cards, clothing, a cell phone plan, or a snack from the vending machine.2 That protected amount is the Personal Needs Allowance, usually shortened to PNA, and Delaware's Division of Medicaid and Medical Assistance sets it for the state.

The idea behind it is dignity. Without a PNA, a resident's whole income would flow to the facility each month and they'd have nothing of their own to spend, no way to buy a birthday gift for a grandchild or replace a worn pair of shoes without asking someone else. The allowance is deliberately modest, but it's the resident's to use however they choose, with no requirement to account to the facility for how they spend it.

Who gets it: any Delaware Medicaid recipient living in a nursing facility (or a comparable institution) whose income is high enough that they owe a patient liability. If a resident's only income is small enough that they owe nothing toward care, the PNA rule doesn't come into play, because they already keep what little they have.

The Delaware Medicaid Personal Needs Allowance in 2026 vs the Federal Floor

For 2026, the Delaware Medicaid Personal Needs Allowance for a nursing facility resident is $75 a month. If both spouses of a married couple live in long-term care, they keep $150 a month combined, $75 each. Delaware raised the figure to $75 effective January 1, 2025, up from the $50 it had been since 2016; older state web pages that still show $44 or $50 are out of date.1

To put that in context, federal law sets a national floor but not a ceiling. Under the federal Medicaid statute, a state's PNA for an institutionalized individual must be at least $30 a month (and at least $60 for a couple where both spouses qualify). That $30 minimum has been frozen since 1988 and has never been adjusted for inflation. States are free to set their allowance higher, and most do, with 2026 figures across the country commonly landing between $50 and $80.2

Delaware's $75 sits comfortably above the federal floor, at two and a half times the national minimum.1 It's a real improvement over the old $50, though it's still a modest sum, so families often plan to supplement it with personal spending money of their own when they can.

How the Money Is Held: The Resident Trust Fund

A resident's $75 has to live somewhere, and there are two normal choices: the resident (or a family member managing their affairs) keeps it in a personal account, or the nursing facility holds it for them in what's usually called a resident trust fund or personal funds account.1 Many families choose the facility account for convenience, so the resident can draw small amounts at the front desk. Federal rules govern how the facility must handle that money, and they're worth knowing.

Under the federal nursing facility requirements, a facility can never require a resident to deposit their personal funds with it, the resident has the right to manage their own money. If a resident does choose to let the facility hold it, the facility has to act as a fiduciary. For a Medicaid resident, any balance above $50 must be kept in an interest-bearing account that's separate from the facility's own operating money, and the interest belongs to the resident. The facility has to keep a full, separate accounting with no commingling of resident money and facility funds, and it must give the resident a statement of the account every quarter and on request.3

Two more protections are built into the same rule. The facility must secure all resident personal funds with a surety bond or equivalent assurance, so the money is protected if something goes wrong. And when a resident dies, the facility has to turn over the remaining funds, along with a final accounting, within 30 days, to whoever is handling the resident's estate.3

One practical caution for families: a resident trust fund balance is a countable asset. If the $75 accumulates month after month without being spent, the account can drift up toward Delaware's $2,000 Medicaid asset limit and put the resident's eligibility at risk.1 It rarely happens quickly at $75 a month, but it's a reason to actually use the allowance, or to watch the balance, rather than let it pile up untouched.

Patient Liability: Where the Allowance Fits in the Math

The clearest way to see the Personal Needs Allowance is to watch it work inside the patient liability calculation, because the PNA is the first thing subtracted, not the last.

Here's the order the state generally follows. It starts with the resident's total monthly income. From that, it protects the PNA, the $75 the resident keeps.1 If the resident has a spouse still living in the community, a further share of income may be set aside for that spouse under Delaware's spousal impoverishment rules. Certain unpaid medical costs, like a Medicare premium or necessary care Medicaid doesn't cover, can come out next. Whatever income is left after those deductions is the patient liability, the amount the resident owes the facility each month, with Medicaid paying the rest of the bill.

So the $75 isn't a bonus the resident receives; it's income the state carves out and lets them keep before figuring what they owe.1 A worked illustration makes it concrete.

What the Facility Must Provide and Can't Bill to Your PNA

A common and costly misunderstanding is that the $75 is meant to buy everyday necessities the facility hands out, soap, a toothbrush, clean towels, a haircut in the on-site chair.1 It isn't. Federal law treats a long list of routine items and services as already paid for by the facility's daily Medicaid rate, which means during a covered stay the facility cannot charge them to the resident or bill them against the Personal Needs Allowance.5

That protected list is specific. Under the federal nursing facility rules, the per-diem rate already covers nursing services, meals and nutrition care, an activities program, room and bed maintenance, and a whole set of routine personal hygiene items and services, including soap, a comb and brush, a razor and shaving cream, a toothbrush and toothpaste, denture adhesive and cleaner, moisturizing lotion, towels and washcloths, over-the-counter drugs, bathing and basic grooming assistance, hair and nail hygiene services, incontinence care and supplies, and basic personal laundry. Because the Medicaid payment already covers those, they can't come out of the $75.5

Why this matters: the allowance is small, and it should go toward things the resident actually chooses, not toward staples the facility is already paid to provide. If a nursing home is charging a resident's personal funds for routine hygiene items or basic laundry, that's a billing problem worth raising with the facility, and, if it isn't resolved, with the state. The PNA is for the extras that make a place feel like the resident's own life, a preferred shampoo, a magazine subscription, a taxi to a family event, not for the basics that come with the bed.

How a VA Pension Works Alongside the Allowance

Veterans and their families often ask a sharp question: if my father gets a VA pension and he's now on Medicaid in a nursing home, does the pension just disappear into the facility bill? The answer, for a single veteran with no spouse and no dependent child, is more favorable than people expect.

Federal law caps that veteran's VA pension at $90 a month once Medicaid is paying for their nursing facility care, but it also protects that $90. The statute specifically says the facility's Medicaid payment can't be reduced by the pension the veteran is allowed to keep, so the $90 doesn't flow to the nursing home and it isn't counted as income that would raise the patient liability. In practice that means a single, childless veteran keeps the $90 VA pension in addition to Delaware's $75 Personal Needs Allowance, for $165 a month in personal money rather than $75.4,1

This is one of the few places in Medicaid where two programs stack in the resident's favor. It applies to the specific situation the law describes, a single veteran with no spouse or child on Medicaid nursing home care, so a veteran with a spouse at home, or a surviving spouse drawing a VA survivors pension, should check their own numbers with the VA before assuming the same result. But for the family whose situation fits, it's real money worth knowing about.

Learn More

Find personalized help understanding your family member's Delaware Medicaid patient liability and personal needs allowance at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.