Updated August 27, 2026. Quick answer: North Carolina is one of the few states that publishes the whole schedule as a table rather than as a formula. If the couple’s countable reserve in the month the continuous period of institutionalization began was “$32,532 or less: PROTECT ALL ASSETS”; “More than $32,532, but not more than $65,064 PROTECT $32,532.” “More than $65,064 but not more than $325,320: PROTECT ONE HALF.” And “More than $325,320 PROTECT $162,660.”
What North Carolina actually sets out
| What the state provides | What it says |
|---|---|
| North Carolina’s name for it | the Community Spouse Resource Allowance (CSRA), manual MA-2231, revised 12/8/2025 |
| What it is called | “The protected share is called the Community Spouse Resource Allowance (CSRA).” |
| Reserve at or under the floor | “$32,532 or less: PROTECT ALL ASSETS” |
| Reserve just above the floor | “More than $32,532, but not more than $65,064 PROTECT $32,532.” |
| The middle band | “More than $65,064 but not more than $325,320: PROTECT ONE HALF.” |
| Above the ceiling | “More than $325,320 PROTECT $162,660.” |
| When the figure can move | “The CSRA does not change unless a different amount is established: a. Through the appeals process as the amount necessary to meet the needs of the community spouse; or b. By subsequent court order; or c. The original assessment is found to be incorrect; or d. The minimum/maximum protection amount was used and that amount has been increased in policy since the assessment was done.” |
| Living together is not required | “It is not required that the community spouse have been living with the a/b at the time of institutionalization to receive spousal resource protection.” |
| If the spouse at home cannot be found | “If the community spouse has not been located by the 45th or 90th day, process the application using only those assets available to the institutionalized spouse.” |
| If the money is not moved | “If protected resources (in the amount of the CSRA) are not transferred to the community spouse’s name/control by the end of the protection period: (1) The resources become countable/available to the Medicaid beneficiary;” |
How it works in practice
- The second band is the one families misread. Between the floor and twice the floor, North Carolina protects the floor itself, not half: “More than $32,532, but not more than $65,064 PROTECT $32,532.” A couple with $60,000 protects $32,532, not $30,000. Half only starts doing the work above $65,064.
- The bands are written as dollar amounts, which makes them checkable and makes them date. The $32,532 floor and $162,660 ceiling in this revision are the figures for 2026; the same manual says the CSRA can be revisited when “The minimum/maximum protection amount was used and that amount has been increased in policy since the assessment was done.”
- Once set, the number is deliberately hard to move. “The CSRA does not change unless a different amount is established: a. Through the appeals process as the amount necessary to meet the needs of the community spouse; or b. By subsequent court order; or c. The original assessment is found to be incorrect; or d. The minimum/maximum protection amount was used and that amount has been increased in policy since the assessment was done.” Four routes, and ordinary changes in the couple’s finances are not among them.
- You do not have to have been living together. “It is not required that the community spouse have been living with the a/b at the time of institutionalization to receive spousal resource protection.” Long separations, and spouses who were already living apart when one entered care, still get the protection.
- There is a written protocol for a missing spouse, with a deadline. The caseworker must try local telephone listings, statements from the applicant’s children and statements from someone who knows the situation; and “If the community spouse has not been located by the 45th or 90th day, process the application using only those assets available to the institutionalized spouse.”
- Protection is not self-executing — the money has to actually move. “If protected resources (in the amount of the CSRA) are not transferred to the community spouse’s name/control by the end of the protection period: (1) The resources become countable/available to the Medicaid beneficiary;” A CSRA calculated and then ignored converts back into countable resources at the end of the protection period.
What the allowance is for, and why protecting the spouse at home is a federal requirement rather than a state kindness, is explained on the community spouse resource allowance page. The date the couple’s resources are counted is its own subject, on the snapshot date page, and the monthly income allowance that runs alongside it is on the MMMNA page. This page is the record for North Carolina.
What this page does not settle
- This page reads the resource half of the rule only. North Carolina’s income allowance for the spouse at home is set by separate administrative letters, and the manual points to a worksheet, the DHB-5122, that this page has not reproduced.
- This page reads one source: North Carolina Aged, Blind and Disabled Medicaid Manual MA-2231, Community Spouse Resource Protection, revised 12/8/2025, Change No. 11-25. It is the state’s own publication on this rule, but no state puts its whole treatment of a couple’s resources in a single document, and a detail that decides your case may sit in one this page did not read.
- The resource rule is one hurdle. The income rules for the spouse at home are separate and are decided on their own numbers, the level-of-care test is separate again, and the transfer-of-assets look-back is separate from all of them. Clearing this rule does not clear any of the others.
- Every quotation here was read against the source on August 27, 2026. The federal minimum and maximum figures are reset each January, and a state can revise its own rule without the page around it changing. Open the source before you rely on a number.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or spend a couple’s savings on the strength of a web page.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
Related: North Carolina’s Long-Term Care Partnership Program status; a separate, policy-based way some families protect assets alongside this spend-down allowance.