Updated September 6, 2026. Quick answer: In Maryland, a Medicaid nursing-facility resident’s Personal Needs Allowance is $109.00/Month; the amount of their own income they keep for personal use each month, with the rest going to the facility as the patient-pay amount toward the cost of care. That is well above the $30/month federal floor set in 1988 and never raised since. Maryland Medical Assistance Program Nursing Home Transmittal No. 312 (PT 05-27, July 10, 2026), Maryland Department of Health states the figure directly.
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Why Maryland’s figure isn’t the federal floor
Federal Medicaid law requires only a $30-a-month personal needs allowance as a floor; a state is free to set its own, higher figure by statute, regulation, or agency policy. Maryland has done exactly that, setting $109.00/Month, effective July 1, 2026 (State fiscal year 2027).
What the allowance covers, and what it doesn’t
The personal needs allowance pays for the things a facility’s daily rate doesn’t cover: clothing, haircuts, snacks, a phone or television, small personal purchases. It is deducted before the rest of a resident’s income is applied to the facility bill as the patient-pay (or post-eligibility treatment of income, PETI) amount. It is not extra money on top of what Medicaid already pays the facility; it is the one slice of a resident’s own income that Medicaid rules guarantee the resident, not the facility, keeps.
One exception or caveat worth knowing
The underlying COMAR regulation (10.09.24.10) establishes only the escalation mechanism (a base $60/month from 2004 adjusted annually up to 5% tied to Social Security COLA), not the current dollar figure; the current number came from the MDH nursing home transmittal cited below.
| Citation | Maryland Medical Assistance Program Nursing Home Transmittal No. 312 (PT 05-27, July 10, 2026), Maryland Department of Health |
| What it says | “Additionally, the personal needs allowance for FY 2027 is $109.00 per month per Medicaid participant.” |
Figures verified against Maryland Department of Health Nursing Home Transmittal No. 312 (PT 05-27, July 10, 2026) and 42 U.S.C. 1396a(q); the COMAR escalation description was not re-checked on September 30, 2026.
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a facility or state caseworker has the final say on any individual case.
Related: use the Medicaid spend-down calculator to estimate how much you would need to spend down to qualify for long-term-care Medicaid in your state.