When one spouse needs nursing home care, one of the first and most common concerns we hear is simple:
“Am I going to lose all of our income?”
It’s a fair question — and an understandably stressful one. The good news is that, in Massachusetts, the answer is no.
The Good News: You Don’t Lose All of Your Income
MassHealth has built-in protections to make sure that the spouse who remains at home is not left without enough income to meet their basic needs. One of the most important of those protections is called the Minimum Monthly Maintenance Needs Allowance, or MMMNA.
While the name may sound technical, the idea behind it is straightforward. If your spouse enters a nursing home and qualifies for MassHealth, most of their income will go toward the cost of care. They are allowed to keep only a small personal needs allowance — currently $72 per month.
However, if you are still living at home, MassHealth does not expect you to live without adequate income. Instead, it guarantees that you are entitled to a minimum level of monthly income to cover your living expenses.
What Is the MMMNA?
The Minimum Monthly Maintenance Needs Allowance (MMMNA) is the amount of monthly income the at-home spouse is protected to receive when their spouse is receiving MassHealth in a nursing home.
In simple terms, it is designed to ensure the spouse at home can continue to pay bills, maintain their household, and live with financial stability.
How the Monthly Income Protection Works in 2026
For 2026, that protected amount starts at $2,555 per month, and in some cases can increase up to $4,066.50 per month, depending on your circumstances.
Here is what that looks like in practice. Imagine your spouse enters a nursing home and receives $3,200 per month in income, while you remain at home and receive $900 per month. Under MassHealth rules, you should have at least $2,555 per month to live on.
Because your current income falls short of that amount, a portion of your spouse’s income can be redirected to you.
The calculation is simple: $2,555 minus your $900 income leaves a difference of $1,655. That means you would receive $1,655 from your spouse’s income each month, bringing your total monthly income up to the protected level. The remaining income would then go toward the cost of the nursing home, after accounting for the small personal needs allowance.
When the Protected Amount Can Increase
In many cases, this minimum amount is not fixed. If your monthly expenses are higher — particularly housing costs like a mortgage, property taxes, insurance, or utilities — MassHealth allows for adjustments.
As those expenses increase, the amount of income you are entitled to keep can also increase, sometimes up to the federal maximum of $4,066.50 per month.
A Common Misconception About Nursing Home Costs
One of the biggest misconceptions is the belief that once a spouse enters a nursing home, all of their income must be paid toward care.
In reality, the system is designed to prevent exactly that outcome. MMMNA exists to ensure that the spouse at home can continue to pay bills, maintain their household, and live with a degree of financial stability.
Income vs. Assets: Why They’re Different Rules
It is also important to understand that this rule applies specifically to income. Separate rules govern how much in savings and other assets the spouse at home can keep, and those protections are equally important in the overall planning process.
How We Help Families Navigate This
At the Senior Resource Center, we work with families every day who are navigating these exact concerns. Understanding how these rules apply to your situation can make a significant difference, not only in qualifying for benefits, but in protecting the financial well-being of the spouse who remains at home.
Final Thoughts: Planning Protects Both Spouses
If you or a loved one are facing a transition to nursing home care, it is worth taking the time to understand these protections. With the right planning, you can ensure that both spouses are supported — not just with care needs, but financially as well.
