Federal law requires Medicaid recipients to contribute to the cost of long-term care. The contribution amount is determined by deducting certain amounts from a recipient's monthly income. One of the permitted deductions is the personal needs allowance (PNA), which is the amount of the Medicaid recipient's own income that can be kept and spent on personal items. After deducting the PNA and other allowable deductions, all remaining income goes toward the cost of care.
The PNA in Washington is $71.12 per month for persons in nursing facilities or institutions, and for persons in residential care, such as in an adult family home or assisted living facility. The PNA for individuals living at home varies and is dependent on marital status. Currently, the PNA for single clients who live at home while receiving Home and Community-Based (HCB) waiver services authorized by the Department of Social and Health Services (DSHS) Home and Community Services (HCS) is set in rule at 100 percent of the Federal Poverty Level (FPL), now $1,074 per month, and may be updated for the calendar year 2022 FPL on April 1. The Federal Benefit Rate (FBR) is the amount of money that the federal government provides for Supplemental Security Income recipients. The FBR varies and is dependent on marital status. For calendar year 2022, the FBR is $841 per month for eligible individuals who are single.
Unless subject to a separate determination of a monthly maintenance needs allowance for a community spouse as specified in rule, beginning July 1 2022, the PNA for clients receiving HCB waiver services authorized by DSHS-HCS while living at home is increased to 300 percent of the FBR and shall not exceed the maximum PNA permissible under the federal Social Security Act.