Oregon Medicaid Spousal Impoverishment 2026: CSRA & MMMNA

Oregon Medicaid spousal impoverishment rules protect the at-home spouse when one partner enters nursing facility care, with Oregon applying the federal maximum asset and income protections.

How Oregon Medicaid Spousal Impoverishment Works

When one spouse enters a nursing facility or qualifies for a home- and community-based services (HCBS) program, Oregon applies federal spousal impoverishment protections under 42 USC § 1396r-5. The rules divide into two parts: a resource (asset) protection for the at-home spouse and an income protection.

Oregon is an income-cap state, meaning the institutionalized spouse must have gross income at or below $2,982/month, or use an Income Cap Trust for any excess. Oregon's income-cap requirement for the applicant does not reduce the community spouse's CSRA or income allowance. Those are calculated independently under the same federal framework.

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

How the CSRA Works

The Community Spouse Resource Allowance (CSRA) is the portion of the couple's countable assets the community spouse gets to keep when the institutionalized spouse applies for Oregon Medicaid long-term care coverage.

The Snapshot Date

Before Oregon calculates the CSRA, the program takes a snapshot of the couple's total countable assets. The snapshot date is the first day of a continuous period of institutionalization, typically the date the institutionalized spouse enters a nursing facility for a stay of at least 30 continuous days.

The snapshot date is significant because the CSRA calculation uses that frozen figure, not the couple's current asset position at the time of the formal Medicaid application.

The Half-of-Assets Formula

Oregon applies this formula: the community spouse keeps half of the couple's total countable assets at the snapshot date, subject to federal minimum and maximum limits.

For 2026:

• Minimum CSRA: $32,532 (if half the couple's assets falls below this, the community spouse still keeps $32,532)
• Maximum CSRA: $162,660 (if half the couple's assets exceeds this, the community spouse keeps $162,660)

Oregon applies the federal maximum, giving Oregon couples the strongest asset protection federal law allows.

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 Portland has the following countable assets at the snapshot date: $150,000 in joint savings, $60,000 in the institutionalized spouse's IRA, and $40,000 in a brokerage account held in the community spouse's name. Total: $250,000.

Half of $250,000 is $125,000. That falls between the $32,532 floor and the $162,660 ceiling, so the community spouse keeps $125,000.

The institutionalized spouse's share is $125,000. Oregon's applicant asset limit is $2,000, so roughly $123,000 must be spent down before Oregon Medicaid eligibility is established.

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 $1,500 face value
• Non-home real estate and investment property

Assets that are exempt from the snapshot include the primary home, one vehicle, household goods and personal effects, prepaid burial contracts, and burial plots.

How the MMMNA Works

The Minimum Monthly Maintenance Needs Allowance (MMMNA) is the income protection for the at-home spouse. It sets the floor and ceiling on how much monthly income the community spouse may keep.

For 2026, Oregon applies:

• Floor (minimum MMMNA): $2,643.75/month (effective 7/1/2025 through 6/30/2026)
• Ceiling (maximum MMMNA in Oregon): $4,066.50/month (effective 1/1/2026 through 12/31/2026)

Oregon applies the federal maximum ceiling of $4,066.50/month.

The Name-on-the-Check Rule

Under federal law, the community spouse keeps all of her own income regardless of amount. If she receives a pension of $3,800/month, she keeps every dollar. This is the "name on the check" rule (42 USC § 1396r-5(b)(2)): income belonging to the community spouse belongs to her alone.

Only the institutionalized spouse's income flows toward the nursing facility cost.

Income Diversion

When the community spouse's own income falls below the MMMNA floor, Oregon allows an income diversion from the institutionalized spouse's income to bring her up to the floor.

How this works in practice: the institutionalized spouse's income is reduced by the Personal Needs Allowance ($81.28/month in Oregon), Medicare Part B premiums, and other deductions. From the remainder, enough is diverted to the community spouse to reach the MMMNA floor. The net remaining amount is the patient liability paid to the nursing facility. Oregon Medicaid covers the balance.

Worked example #1 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.

The community spouse receives $1,100/month from Social Security. The MMMNA floor is $2,643.75/month. Her shortfall is $1,543.75/month. The institutionalized spouse receives $2,400/month from Social Security and a pension. After subtracting the $81.28 personal needs allowance and $185 Medicare Part B premium, the institutionalized spouse has $2,133.72 available. Of that, $1,543.75 is diverted to the community spouse. The remaining $589.97 goes to the nursing facility as patient liability. Oregon Medicaid pays the facility balance.

The community spouse moves from $1,100/month to $2,643.75/month.

Reaching the MMMNA Ceiling

The community spouse can reach the $4,066.50 ceiling if her actual shelter costs (rent, mortgage, taxes, insurance, utilities) exceed the $793.13/month federal shelter standard. The excess raises the allowable income toward the ceiling.

Oregon housing costs, especially in the Portland metro area, frequently exceed this threshold, giving many Oregon community spouses a path to higher income protection.

The Home

The primary residence is exempt from Medicaid eligibility calculations as long as it is the community spouse's principal residence. The home's equity is not counted as a resource.

For 2026, the Oregon home equity cap is $752,000. Because the community spouse lives in the home, the equity cap rarely affects eligibility.

One important note: Oregon's estate recovery program is among the more active in the country and can reach non-probate assets in some cases. The home is protected while the community spouse lives there, but families should be aware of the estate recovery implications after both spouses pass. Consult an Oregon elder law attorney about planning options before or after the Medicaid application.

Oregon applies a 60-month lookback on asset transfers. Transferring the home to a child (outside limited exceptions) within that window can create a penalty period.

Assets That Are Exempt

Beyond the home, these asset categories are excluded from the Medicaid eligibility calculation:

• Primary residence (equity up to $752,000 while the community spouse lives there)
• One vehicle of any value used for transportation of either spouse
• Household goods and personal effects (furniture, clothing, appliances)
• Prepaid irrevocable burial contracts
• Burial plots for the applicant and immediate family
• Life insurance with face value of $1,500 or less
• Property essential to self-support (working farm or small business tools)

Retirement accounts (IRAs, 401(k)s) held by either spouse are countable in Oregon. Oregon does not offer a special exemption for the community spouse's retirement accounts.

Oregon Medicaid Spousal Impoverishment and the Application Process

Who Administers This

Oregon Medicaid for long-term care is administered by the Oregon ODHS Aging and People with Disabilities program. The community spouse's CSRA and MMMNA are calculated by ODHS as part of the nursing home Medicaid application.

How to Request a Resource Assessment

A couple does not need to file a full Medicaid application to request a resource assessment that locks in the snapshot date. Requesting it at or near the time of nursing facility admission preserves the snapshot when documentation is clearest. Apply at ONE.Oregon.gov or by phone at 1-800-699-9075.

Long-term care facilities are required by federal law to inform residents and their spouses of the right to request this assessment.

The Income Cap Trust Dimension

Because Oregon is an income-cap state, if the institutionalized spouse's gross income exceeds $2,982/month, an Income Cap Trust is required. The community spouse's CSRA and MMMNA are not affected by whether an Income Cap Trust is in place. Both calculations proceed under the same federal spousal impoverishment framework. For more on income eligibility, see Oregon Medicaid eligibility and income limits.

The Application Process

Oregon Medicaid long-term care applications follow these general steps. See the Oregon Medicaid how-to-apply guide for a detailed walkthrough.

1. Gather documentation: bank and brokerage account statements at the snapshot date, property records, insurance policies, income statements.
2. Apply online at ONE.Oregon.gov, by phone at 1-800-699-9075, or in person at a local ODHS office.
3. Request a resource assessment early to lock in the snapshot date.
4. ODHS calculates the CSRA and MMMNA and notifies both spouses.
5. The community spouse has the right to appeal the CSRA or MMMNA determination.

Medicaid Planning Strategies to Consider

Oregon's federal-maximum CSRA and MMMNA give couples strong starting protections. Cases where additional planning may help include situations where countable assets substantially exceed the $162,660 CSRA ceiling. Options include:

• Converting countable assets to exempt ones: prepaying burial contracts, making home repairs or improvements, or purchasing a vehicle.
• Community-spouse annuities: an irrevocable, non-assignable, actuarially sound annuity can convert excess assets into an income stream. Must meet Deficit Reduction Act 2005 requirements, including naming Oregon as primary remainder beneficiary.
• Fair hearing: if the CSRA alone does not generate enough income to reach the MMMNA, a fair hearing can result in a higher resource allowance.

For broader options, see Medicaid planning strategies.

Given Oregon's active estate recovery program, Oregon families often benefit from consulting an Oregon-licensed elder law attorney both before the Medicaid application and when planning for what happens after the institutionalized spouse passes.

Learn More

• Oregon Medicaid Eligibility and Income Limits
• How to Apply for Oregon Medicaid
• Medicaid Planning Strategies

Find personalized help understanding Oregon 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.