Delaware Medicaid Spousal Impoverishment 2026: CSRA Guide

Delaware Medicaid spousal impoverishment rules protect the at-home spouse when a partner enters nursing home care. The community spouse can keep up to $162,660 in assets and up to $4,066.50 per month in income under the 2026 federal maximums.

How Delaware Medicaid Spousal Impoverishment Works

When one spouse enters a nursing facility or qualifies for a home- and community-based services (HCBS) waiver, Delaware Medicaid applies federal spousal impoverishment protections under 42 U.S.C. § 1396r-5. These protections have two components: a resource (asset) allowance for the at-home spouse, and an income allowance.

Delaware's own regulations tie the ceiling on both allowances to federal law: the resource allowance may be "no more than [the] current maximum resource allowance determined by Federal law" ($162,660 for 2026), and the income allowance is capped at the federal maximum monthly maintenance needs allowance ($4,066.50 for 2026).1,2

The at-home spouse is called the community spouse. The spouse entering long-term care is called the institutionalized spouse.

How the Delaware Medicaid Spousal Impoverishment CSRA Works

The Community Spouse Resource Allowance (CSRA) is the amount of countable assets the community spouse keeps when the institutionalized spouse applies for Medicaid long-term care coverage.

The Snapshot Date

Before calculating the CSRA, Delaware takes a snapshot of the couple's total countable assets. Delaware's rules set that snapshot at "the beginning of the first continuous period of institutionalization," which in practice is the date the institutionalized spouse enters the facility.2

The CSRA is calculated from that frozen snapshot figure, not from the couple's current assets at application. Assets that have grown or declined since the snapshot still produce the CSRA from the original figure.

The Half-of-Assets Formula

Delaware's rules (DSSM 20910.10 and 20930) set the community spouse resource allowance at the greater of a state spousal share or half of the couple's combined countable resources at the snapshot date, and "in no case more than [the] current maximum resource allowance determined by Federal law."

• Maximum CSRA: $162,660 for 2026. If half the couple's assets exceeds this, the community spouse keeps $162,660.1,2
• Minimum CSRA: ask DMMA, because Delaware's floor is genuinely unsettled. DSSM 20910.10 still prints a state spousal share of $25,000, the level Delaware Senate Bill 99 set for applications filed on or after 10/1/1993, while the same section says the minimum and maximum resource allowances "increase on January 1 of each year by Federal law." The 2026 federal minimum resource standard published by CMS is $32,532. Delaware's regulation ties only its ceiling to federal law explicitly, and no Delaware source we could find states which floor DMMA actually applies. Confirm the floor with DMMA before you rely on either figure. For a couple with modest assets the difference is more than $7,500.1,2

A worked example illustrating the formula:

The figures below are hypothetical and shown only to illustrate how the calculation works. They are not a real case and not a prediction of your own result.

A couple in Wilmington has $200,000 in joint savings at the snapshot date. Half of $200,000 is $100,000, which is below the $162,660 ceiling and well above either candidate floor, so the community spouse keeps $100,000. (Because half the assets clears both the $25,000 and the $32,532 figures, the unsettled floor doesn't change this couple's result; it only matters when half the assets is small.)1

The institutionalized spouse's share is the remaining $100,000. The Medicaid applicant may keep $2,000 of that. The rest ($98,000) must be spent down before Medicaid long-term care coverage begins.2

What Counts as a Countable Asset

Both spouses' assets are pooled for the snapshot regardless of whose name is on the account. Countable assets generally include:

• Checking and savings accounts
• CDs and money market funds
• Stocks, bonds, and mutual funds
• Both spouses' IRAs and 401(k)s
• Cash value of life insurance above certain thresholds
• Non-home real estate

Excluded resources under Delaware's manual (DSSM 20310):

• The principal place of residence and adjoining land, only if certain conditions are met: the individual intends to return home, or a spouse and/or dependent relative uses the home during the absence
• One automobile per household (conditions apply)
• Designated burial funds of $1,500
• A prepaid burial contract that cannot be revoked2

This is the list Delaware's regulations state. If a resource you're counting on isn't named here (a retirement account, household goods, a second vehicle), don't assume it's excluded; ask DMMA before you plan around it.

How the MMMNA Works

Two separate federal standards bracket the monthly income allowance the community spouse may receive. They run on different annual clocks, and they are not the two ends of one published range:

• Minimum Monthly Maintenance Needs Allowance (MMMNA): $2,705.00/month, effective 7/1/2026 through 6/30/2027. This one is adjusted with the federal poverty level every July 1 (Alaska $3,381.25; Hawaii $3,111.25).
• Maximum Monthly Maintenance Needs Allowance: $4,066.50/month, effective 1/1/2026. This one is adjusted each January.1

Delaware doesn't apply the MMMNA figure directly. Its regulation (DSSM 20995.1.2.1) computes the community spouse monthly income allowance as "the amount of income necessary to bring the spouse's monthly otherwise available income up to the applicable percent of the FPL for two, plus an additional amount for excess shelter," subject to the federal cap above.2

The Name-on-the-Check Rule

Under federal law at 42 U.S.C. § 1396r-5(b)(2), the community spouse keeps all of her own income regardless of amount. Only the institutionalized spouse's income flows toward the nursing facility cost.

Income Diversion

When the community spouse's own income falls short of her maintenance needs allowance, Delaware allows an income diversion from the institutionalized spouse's income to make up the difference.

How this works: the institutionalized spouse's income is reduced by the Personal Needs Allowance, any Medicare Part B premium, and other deductions. From the remainder, enough is diverted to the community spouse to meet her allowance. The net remaining amount goes to the nursing facility as patient liability. Delaware Medicaid covers the rest of the bill.2

One caution on the Personal Needs Allowance. Delaware raised it to $75/month for an individual ($150 for married couples) effective January 2025, and DMMA's own program page states a nursing facility resident "may keep $75.00 of his monthly income for his personal needs." But the section that governs the post-eligibility calculation for an institutionalized spouse (DSSM 20995.1.1, the one that applies in a spousal-impoverishment case) reads "$30 per month for SSI recipients, and $75 per month for all others." The manual doesn't reconcile the two. If the institutionalized spouse receives SSI, confirm with DMMA which amount it is applying.2

Worked example illustrating income diversion:

The figures below are hypothetical and shown only to illustrate how the calculation works. They are not a real case and not a prediction of your own result.

Say the community spouse receives $1,600/month in Social Security and her computed maintenance needs allowance works out to the $2,705.00/month federal minimum standard. Her shortfall is $1,105.00/month. If the institutionalized spouse receives $2,300/month, the state first subtracts his Personal Needs Allowance and his Medicare Part B premium; enough of what remains is then diverted to the community spouse to cover the $1,105.00 shortfall, and the balance goes to the nursing facility as patient liability.1,2

The community spouse's income rises from $1,600 to $2,705.00/month.1

Reaching the Maximum Monthly Maintenance Needs Allowance

Delaware's formula adds "an additional amount for excess shelter" on top of the base allowance, so a community spouse with high shelter costs (rent, mortgage, property taxes, insurance, utilities) can have her allowance increased, up to the $4,066.50 federal maximum. The federal community spouse monthly housing allowance used in that calculation is $811.50/month effective 7/1/2026, the standard for every state except Alaska and Hawaii, Delaware included.1,2

The Home

Two separate rules govern the home, and it helps to keep them apart.

The residence exclusion. Delaware excludes the principal place of residence and adjoining land "if certain conditions are met": the individual intends to return home, or a spouse and/or dependent relative uses the home during the absence. A community spouse living in the home satisfies the second condition.2

The home-equity cap. Separately, an individual whose home equity exceeds "the home equity cap as set by federal regulations" is not eligible for Medicaid payment of long-term-care services, unless the home is lawfully occupied by a spouse, a dependent child under 21, or a blind or disabled child of any age. For a couple where the community spouse stays in the home, that exception is what matters most.2

Which cap figure applies in Delaware is not clear from the state's own manual. DSSM points to section 20320.7.E for the "current home equity cap," but that table stops at $525,000 effective January 1, 2012, so it names no current figure. The 2026 federal home-equity limits published by CMS are a $752,000 minimum and a $1,130,000 maximum, and states set their cap somewhere in that band. Confirm with DMMA which cap it applies before relying on either number.2

Delaware also applies a 60-month look-back to uncompensated transfers made on or after 2/8/06. Consult an elder law attorney about the home if estate recovery or transfer timing is a concern.2

The Application Process

Delaware long-term care Medicaid is administered by DMMA. Applications can be submitted:

• Online via ASSIST at assist.dhss.delaware.gov
• In person at DMMA or through the Delaware Aging and Disability Resource Center (DARC)

For a step-by-step walkthrough, see How to Apply for Delaware Medicaid.

Requesting a Resource Assessment

A couple can request a resource assessment to lock in the snapshot date before formally applying for Medicaid. Doing this early, ideally at the time of nursing facility admission, captures the asset picture when documentation is freshest. Contact DMMA to initiate.

Learn More

Find personalized help understanding Delaware Medicaid spousal impoverishment rules 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.