Updated September 6, 2026. Quick answer: In North Carolina, a Medicaid nursing-facility resident’s Personal Needs Allowance is $70.00/Month (individual); $140.00/Month (married couple); 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. NC DHHS, NC Medicaid, Division of Health Benefits: Aged, Blind and Disabled Medicaid Manual, MA-2270 “Long Term Care Need and Budgeting” states the figure directly.
Why North Carolina’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. North Carolina has done exactly that, setting $70.00/Month (individual); $140.00/Month (married couple), effective document revised December 8, 2025 (Change No. 11-25).
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.
| Citation | NC DHHS, NC Medicaid, Division of Health Benefits: Aged, Blind and Disabled Medicaid Manual, MA-2270 “Long Term Care Need and Budgeting” |
| What it says | “Personal Needs Allowance (PNA) (1) $70 for an institutionalized individual, or (2) $140 for a married couple who share a room and both receive Medicaid” |
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.