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Non-Spousal-Impoverishment Family Maintenance Allowance Maximum $1,173.77 1/1/2026 Yes Community Waivers Basic Needs Allowance $1,192.00 5/1/2026 Yes Community Waivers Personal Maintenance Allowance Maximum $2,982.00 1/1/2026 Yes 39.4.4 LTC Spousal Impoverishment Post-Eligibility Allowances and Community Spouse Asset Share Description Amount Effective Updated Annually? Community Spouse Lower Income Allocation Limit $3,606.66 7/1/2026 Yes Shelter Base Amount $1,082.00 7/1/2026 Yes Community Spouse Income Allocation Maximum $4,066.50 1/1/2026 Yes Dependent Family Member Income Allowance Maximum $901.67 7/1/2026 Yes Dependent Family Member Income Allowance Standard $2,705.00 7/1/2026 Yes Community Spouse Asset Share (CSAS) Maximum $162,660 1/1/2026 Yes 39.4.5 Family Care, Family Care Partnership, or PACE Group B Plus Cost Share Cap Item Amount Effective Updated Annually? Cost Share Cap for Group B Plus Family Care, Family Care Partnership, or PACE $4,015.55 1/1/2026 Yes 39.4.6 Institutional Cost of Care Values Item Amount Effective Updated Annually? Daily Average Private Pay Nursing Home Rate $352.06

1/1/2026 Yes Monthly Average Private Pay Nursing Home Rate $10,708.49 1/1/2026 Yes Monthly Rate for State Centers for Persons with Developmental Disabilities $47,853.02 1/1/2026 Yes 39.4.7 SSI Reference Values Item Group Size 1 Group Size 2 Effective Updated Annually? Federal SSI Payment Level $994.00 $1,491.00 1/1/2026 Yes State Supplementary Payment (SSP) $92.16 $145.26 05/01/2026 No SSI E Supplement $105.59 $379.90 05/01/2026 No Substantial Gainful Activity Threshold for Non- Blind Disabled Individuals $1,690.00 N/A 1/1/2026 Yes Substantial Gainful Activity Threshold for Blind Individuals $2,830.00 N/A 1/1/2026 Yes 39.4.8 Long-Term Care Home Equity Limit Item Amount Effective Updated Annually?