Personal Needs Allowance

When someone is on Long-Term Care Medicaid in a nursing home, most of their income goes toward the cost of their care. But they do not hand over every dollar. Each month they keep a small amount called the personal needs allowance (PNA). This guide explains what it is, how much it is in each state for 2026, and how it can be used.

Figures change periodically. Double-check current amounts before relying on them.

What the personal needs allowance is

The personal needs allowance is the part of a nursing home resident’s monthly income that they keep for personal expenses. It is the first deduction when the state figures how much the resident pays the nursing home (their patient liability).

Federal law requires every state to allow at least $30 a month. States can set a higher amount, and most do. In 2026, state amounts range from $30 to $200 a month.

2026 personal needs allowance by state

Figures are taken from each state’s 2026 guide on this site. Some states set a different amount for residents of assisted living or for people on home care waivers, where the person must also pay for room and board.

What the allowance is for

The PNA pays for personal items and services that Medicaid and the nursing home do not cover. Common uses:

• clothing and shoes;
• haircuts and beauty or barber services;
• personal toiletries beyond the basics the facility provides;
• snacks, books, magazines and newspapers;
• phone, cable or internet service in the room;
• gifts and cards for family;
• outings and activities;
• dental, vision or hearing items not covered by insurance;
• small payments toward a prepaid funeral, in some cases.

The nursing home must provide routine personal hygiene items as part of its care. It cannot charge the resident’s allowance for things Medicaid already pays for.

Who manages the money

The resident can manage their own allowance, or ask someone else to:

• A family member or agent under a power of attorney can manage it.
• The nursing home can hold the money in a resident trust account, if the resident agrees in writing. Federal rules require the facility to keep these funds separate, provide quarterly statements, and pay interest on balances over a set amount.

Watch the balance

The PNA is meant to be spent. If it builds up, it can push the resident over the asset limit (often $2,000 in 2026). For example, a resident who keeps $75 a month and spends nothing would build up $900 in a year. Combined with other money, that could put them over the limit at renewal.

Nursing homes must notify residents (or their representative) when a resident trust account balance comes within $200 of the SSI resource limit, so the money can be spent before it affects eligibility.

VA pension and the PNA

A veteran or surviving spouse in a Medicaid nursing home with no dependents generally has their VA pension reduced to $90 a month. That $90 is protected for personal use and is not counted toward patient liability. Several states also set a higher PNA for veterans. See How VA benefits count for Medicaid.

PNA for people with earned income

Some states allow residents who work (for example, in a sheltered workshop) to keep an extra amount of their earnings on top of the PNA. Ohio, for example, allows up to $65 of earned income in addition to its $75 allowance.

Worked example

Mary lives in a Medicaid nursing home in Florida. Her gross Social Security is $1,850 a month, and she pays a Medicare Part B premium of $202.90 and a supplement premium of $150.

Mary keeps $160 a month for her own use. See Patient liability for more on the calculation.

Can the allowance be raised?

The PNA is set by the state. In some states, it can be raised in limited situations, such as for a guardianship fee or for residents with earned income. A request is usually made through the caseworker, and a fair hearing is available if it is denied.

Common questions

Can the nursing home take my personal needs allowance? No. It is yours. The nursing home can hold it only with your written agreement.

What happens to my PNA when I die? Any balance in a resident trust account must be conveyed to the person handling the estate, and it may be subject to estate recovery.

Does the PNA apply to home care? People on home care waivers usually keep a larger amount to pay for housing and food, called a maintenance needs allowance. The amount varies by state.

Common questions families ask

Who pays for clothing? The resident, from their personal needs allowance, unless the family helps.

Can family give the resident extra spending money? Yes, but cash gifts to the resident count as income in the month received, and any balance counts toward the asset limit. Many families pay vendors directly for items such as clothing or haircuts instead of giving cash, which usually does not count as income to the resident. Rules on in-kind help vary.

Can the allowance be used for a prepaid funeral? In some cases, yes. Spending the allowance on a prepaid funeral contract is an allowed use of money, subject to state rules.

What if the resident is in the hospital for part of the month? The allowance usually continues. Rules for patient liability during hospital stays vary.

Keeping track

A simple monthly record helps: how much came in, what was spent, and the ending balance. If the nursing home holds the money, review the quarterly statement. If the balance approaches the asset limit, plan a purchase, such as new clothing, a hearing aid battery supply, or a contribution to a prepaid funeral, before the next renewal.

When the allowance is not enough

Many families find the allowance does not stretch far. Some options:

• check whether the state allows extra deductions for things like guardianship fees;
• make sure all health insurance premiums are subtracted from patient liability, which can free up money;
• ask whether a veteran qualifies for the protected $90 VA amount or a higher state allowance for veterans.

A {L} can review the patient liability calculation and make sure the resident keeps everything they are entitled to.

The PNA in assisted living and home care

Residents of assisted living who get Medicaid help through a waiver usually pay for their own room and board. To make that possible, states let them keep more of their income than a nursing home resident, often a set amount meant to cover rent, food and personal needs. People getting care at home keep an allowance to cover their household costs. These amounts are separate from the nursing home PNA in the chart above.

Related guides

• Patient liability
• What counts as income?
• Income limits by state
• State guides

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.