“BREAKING NEWS: CMS shares updated Medicaid income, resource standards,” by Lois A. Bowers, McKnights Senior Living
“The Centers for Medicare & Medicaid Services on Tuesday announced Medicaid income and resource standards that will go into effect Jan. 1[,2026]. … The SSI FBR will be $994 for individuals and $1,491 for couples beginning Jan. 1. The CPI increase for 2026 will be 3%. The CPI increase since September 1988 is 171.1%.
Additionally starting Jan. 1, CMS said:
- The SSI resource standard will be $2,000 for individuals and $3,000 for couples.
- The income cap limit for individuals will be $2,982.
- The earned income break-even point will be $2,073 for individuals and $3,067 for couples.
- The unearned income break-even point will be $1,014 for individuals and $1,511 for couples.
- The substantial gainful activity limit will be $1,690, and the blind SGA will be $2,830.
Also effective Jan. 1:
- Regarding spousal impoverishment, the maximum monthly maintenance needs allowance will be $4,066.50.
- For community spouse resources, the minimum resource standard will be $32,532, and the maximum will be $162,660.
- The minimum home equity limit will be $752,000, and the maximum will be $1.13 million.
Amounts for the minimum monthly maintenance needs allowance and the community spouse monthly housing allowance were announced in May and became effective July 1.”
LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform:
If these numbers don’t make any sense to you, you’re not alone. Medicaid eligibility has been called a “Serbonian bog” of confounding complexity. Basically, what you need to know is that Medicaid LTC eligibility is very generous and becomes more so, increasing with inflation, every year. (If you really want to know more, hire Stephen Moses – smoses@centerltc.com – to explain it to you and your team on a Zoom call.) One example, the home equity exemption is huge – from $752,000.00 (most states) to $1,130,000.00 (13 states) – depending on the state in 2026. It jumps to a full $1 million everywhere effective January 1, 2028 due to the One Big Beautiful Bill Act. Find the CMS bulletin with all the details here. We summarize these changes annually in the Center for LTC Reform’s members-only website, The Zone, here. You’ll find every year listed from 1991 to 2026. To access this information in The Zone, you’ll need your user name and password. If you don’t have those at your fingertips, contact Damon at 206-283-7036 or damon@centerltc.com.