Montana Medicaid Spousal Impoverishment 2026: CSRA Guide

When a husband or wife moves into a nursing home, the financial ground shifts fast for the spouse who stays home. Montana Medicaid spousal impoverishment rules protect that at-home spouse: in 2026, they can keep between $32,532 and $162,660 in countable assets and a monthly income floor of $2,705.00. This guide explains exactly how those protections work through Montana Medicaid.1

How Montana Medicaid Spousal Impoverishment Works

When one spouse needs nursing-facility care or a home- and community-based services waiver, the couple must meet strict asset and income limits to qualify. Without protections, the healthy spouse at home could be left nearly penniless while paying for a partner's care. Federal spousal impoverishment law, codified at 42 U.S.C. 1396r-5 (Section 1924 of the Social Security Act), prevents that by reserving a portion of the couple's resources and income for the community spouse, the partner who remains at home.1

Montana applies these federal rules through the Montana Department of Public Health and Human Services (DPHHS), which sets Medicaid policy and determines eligibility. The two protections are the Community Spouse Resource Allowance (CSRA) on assets and the Minimum Monthly Maintenance Needs Allowance (MMMNA) on income.

Montana is a medically needy spend-down state. An applicant whose income exceeds the medically needy income level can still qualify by applying excess income toward incurred medical and long-term-care costs, without needing to establish a Qualified Income Trust (Miller Trust).3

The Montana CSRA: How Much Can the Community Spouse Keep?

The Community Spouse Resource Allowance determines how much of the couple's combined countable assets the at-home spouse may keep.

Calculating the CSRA. DPHHS takes a snapshot of the couple's total countable assets when the Medicaid application is filed. The community spouse keeps half of that amount, subject to a federal floor and ceiling. Montana applies the full federal range: the protected share is never less than $32,532 and never more than $162,660 in 2026.1

• Minimum CSRA ($32,532). Even if half the couple's assets falls below this figure, the at-home spouse keeps at least $32,532.1
• Maximum CSRA ($162,660). Even if half the couple's assets exceeds this amount, the protected share is capped here.1

In practice: a couple with $60,000 in countable assets leaves the community spouse $30,000 (half). A couple with $22,000 leaves the community spouse the full $22,000, because the minimum applies. A couple with $380,000 leaves the community spouse $162,660, because the maximum caps the share.1

Countable vs. exempt assets. Not everything the couple owns counts toward the snapshot. Assets that are exempt include:

• The primary home, as long as the community spouse lives there (subject to the home-equity limit below)
• One vehicle used for household transportation
• Household furnishings and personal belongings
• Prepaid irrevocable funeral and burial contracts

Most financial accounts, second properties, and the institutionalized spouse's retirement accounts count as countable assets.3

The institutionalized spouse's share. After the community spouse's CSRA is set aside, the applicant must spend their remaining countable assets down to Montana's $2,000 individual resource limit before Medicaid will pay for care.3

Income Protection: The MMMNA in Montana

The MMMNA is the income counterpart to the CSRA. It sets the minimum monthly income the at-home spouse is entitled to keep so the couple's income is not entirely consumed by the cost of the institutionalized spouse's care.

How the MMMNA range works. The federal MMMNA floor is $2,705.00 per month (effective July 1, 2026 through June 30, 2027; the floor resets each July). The ceiling is $4,066.50 per month, effective January 1, 2026. Montana follows these federal figures directly.1

If the community spouse already has income at or above the floor from their own sources (Social Security, a pension, investments), no income is diverted from the Medicaid recipient. If the community spouse's own income falls short, they receive a monthly allocation from the institutionalized spouse's income to bring them up to the MMMNA.1

The excess-shelter adjustment. A community spouse whose shelter costs are high can qualify for an MMMNA above the floor. When the at-home spouse's shelter costs (rent or mortgage principal and interest, property taxes, homeowner's insurance, and a utility allowance) exceed a federal shelter standard, the excess is added to the base allowance, raising the MMMNA up to the $4,066.50 ceiling. Because the shelter standard itself is a federal figure that resets periodically, confirm the current amount with DPHHS before relying on a specific number.1

Requesting a higher allowance. If the standard calculation does not adequately cover the community spouse's living expenses, or if exceptional circumstances create unavoidable costs, Montana provides a fair hearing process to raise the allowance. Presenting itemized monthly expenses (rent or mortgage statements, utility bills, property-tax records) is the most effective way to support a higher MMMNA. An elder-law attorney can help build that case.

Montana's Medically Needy Spend-Down

Montana operates a medically needy program for long-term care, meaning applicants who exceed the medically needy income level can still qualify by incurring and applying medical expenses at least equal to the excess. Montana does not impose a 300%-of-SSI income cap on long-term-care eligibility, and no Qualified Income Trust or Miller Trust is required.3

In a nursing facility, the resident's income above allowances is applied toward the monthly care bill, and DPHHS pays the remainder. The Montana nursing-facility Personal Needs Allowance is $50 per month (a resident who receives only SSI keeps $30).3

The Home Exemption and Equity Limit

The primary home is exempt while the community spouse lives in it and the equity is below the home-equity limit. Montana applies the federal-minimum home-equity limit of $752,000 for 2026. That cap does not apply at all while a community spouse or dependent child lives in the home, so the home is fully protected during the community spouse's lifetime.2

Montana Estate Recovery After Death

After the institutionalized spouse passes away, Montana estate recovery may seek reimbursement for the cost of care from the deceased recipient's estate. Federal law prevents any recovery while the community spouse is alive, and no recovery runs against the community spouse's own estate during their lifetime, because the community spouse was never the Medicaid recipient. Montana does, however, use an expanded (not probate-only) estate definition once recovery does begin, reaching some property that passes outside probate. For how Montana defines the recoverable estate and its exceptions, see our Montana Medicaid estate recovery guide.4

The Look-Back Period

Montana applies a 60-month (five-year) look-back to uncompensated asset transfers when determining long-term-care eligibility. Gifts or below-market-value transfers within five years of the application date can trigger a penalty period during which Medicaid will not pay for care. Transfers between spouses are exempt, so assets can be retitled into the community spouse's name without penalty, but the snapshot valuation still counts all couple assets regardless of titling.3

How to Apply for Montana Long-Term Care Medicaid

Learn More

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.