Paying for Care
Medicaid Nursing Home Eligibility: Income, Assets and Spouses
Who Qualifies for Medicaid Nursing Home Care?
Medicaid nursing home coverage goes to people who need a nursing home level of care and meet their state's income and asset limits. In most states for 2026, that means countable assets of about $2,000 for a single person and, in states with an income cap, monthly income up to $2,982. A spouse at home can keep between $32,532 and $162,660 in assets, depending on the state. The Medicaid long-term care checker shows your state's numbers.
Medicaid nursing home coverage is how most families end up paying for long-term nursing home care once savings run low. Medicare stops after short-term rehab, and Medicaid is the program that pays for a long stay. To qualify, your parent has to meet two tests: a medical one (needing a nursing home level of care, as the state defines it) and a financial one (income and assets under the state’s limits). This guide gives the 2026 numbers, explains how a spouse at home is protected, and walks through the look-back rule and estate recovery.
Each state runs its own program within federal rules, so the details below vary. Use the Medicaid long-term care checker to see your state’s limits, and confirm everything with your state Medicaid agency before you apply.
How Medicaid Nursing Home Eligibility Works
Medicaid pays for nursing facility care only in homes certified as Medicaid nursing facilities, and only for people who are eligible and have no other way to pay. CMS lists 14,151 of the 14,690 nursing homes it tracks as Medicaid certified (data from August 2026). You can see which homes near your parent accept Medicaid on the nursing home finder and on state lists such as Ohio nursing homes that accept Medicaid.
The medical test. Every state sets its own nursing facility “level of care” criteria, usually based on how much help a person needs with daily activities and medical care. A state assessor or the nursing home completes the review. People with a serious mental illness or intellectual disability also go through a federal screening called PASRR before admission.
The financial test. Medicaid counts your parent’s income and countable assets. A married couple’s assets are counted together, then split under the spousal rules explained below.
No waiting lists. Medicaid.gov says states must cover nursing facility services for adults who need them and can’t put them on waiting lists, unlike most home care programs. That’s why a nursing home bed is sometimes available through Medicaid faster than help at home.
Usually no move. If your parent enters a home privately or after a Medicare stay, and the home is Medicaid certified, your parent can usually stay in the same home when Medicaid starts paying. If it isn’t certified, your parent would have to move.
The 2026 Medicaid Nursing Home Income and Asset Limits
CMS publishes the federal standards states build on. These figures come from the CMS bulletin of April 27, 2026.
| 2026 federal standard | Amount |
|---|---|
| SSI federal benefit rate, individual | $994 a month |
| SSI federal benefit rate, couple | $1,491 a month |
| Income cap (300% of the SSI rate), used by many states | $2,982 a month |
| SSI resource limit, individual / couple | $2,000 / $3,000 |
| Spousal protected resources (CSRA), minimum to maximum | $32,532 to $162,660 |
| Spouse’s minimum monthly income allowance (from July 1, 2026) | $2,705 ($3,381.25 in Alaska, $3,111.25 in Hawaii) |
| Spouse’s maximum monthly income allowance | $4,066.50 |
| Home equity limit, range states can choose | $752,000 to $1,130,000 |
Income. Many states use the $2,982 income cap for nursing home Medicaid. Some states let people with income above the cap qualify through a qualified income trust; Delaware calls it a Miller trust, and Oregon’s rule refers to a qualifying trust. Others, such as Pennsylvania and the District of Columbia, also publish a medically needy or spend-down standard for people with higher income.
Assets. Most states keep the $2,000 asset limit for a single person. Each state lists what it counts and what it excludes, and some set a higher limit, as the next section shows.
Medicaid Nursing Home Limits in Selected States
These are the limits each state publishes for nursing home Medicaid. Follow the link to your state’s page for its program, waiver and ombudsman. A blank cell means the state’s own page states its rule another way.
| State | Program | Income limit (single) | Asset limit (single) | Personal needs allowance |
|---|---|---|---|---|
| Alabama | Alabama Medicaid | $2,982 a month | $2,000 | |
| California | Medi-Cal | $130,000 through June 30, 2027 | ||
| District of Columbia | DC Medicaid | $2,982 a month | $4,000 | |
| Florida | SMMC Long-Term Care | $2,982 a month | $2,000 | $160 |
| Georgia | Aged, Blind and Disabled Medicaid | $2,982 a month | $2,000 | $70 |
| Illinois | HFS Medicaid Long Term Care | $17,500 | ||
| Massachusetts | MassHealth | $2,000 | $72.80 | |
| Michigan | Michigan Medicaid | $2,982 a month | $9,950 (nursing home and waiver groups; $2,000 in some other groups) | $60 |
| New York | New York State Medicaid | $32,396 | $50 | |
| North Carolina | NC Medicaid | $2,000 | $70 | |
| Pennsylvania | Medical Assistance | $2,982 a month | $2,000 plus a $6,000 disregard | $60 |
| Texas | Texas Medicaid (MEPD) | $2,982 a month | $2,000 | $75 |
A few details matter here. California’s $130,000 limit applies through June 30, 2027; Medi-Cal says it drops to $21,000 for one person starting July 1, 2027. In Pennsylvania, the $2,000 limit with the $6,000 disregard applies when income is at or below $2,982, and the limit is $2,400 above it. New York’s figure is its 2026 resource level for a household of one.
What Happens to Your Parent’s Income After Approval
Qualifying doesn’t make the nursing home free. After approval, Medicaid uses a “post-eligibility” calculation to set how much of your parent’s own monthly income goes to the nursing home, often called the patient’s share.
Medicaid.gov describes it this way: start with total income, then subtract
- a personal needs allowance, which federal rules set at no less than $30 a month (states set their own amount, from $45 in Louisiana and Utah to $160 in Florida);
- a monthly income allowance for a spouse at home, if the income is actually given to the spouse;
- a family allowance, if other dependent family members live at home;
- medical expenses your parent pays that Medicaid doesn’t cover, such as health insurance premiums.
Whatever income is left goes to the nursing home each month, and Medicaid pays the rest of the Medicaid rate. Under Medicaid rules, the home can’t charge extra for nursing care, meals, activities, routine hygiene items or the room, but it can charge for a private room that isn’t medically needed, a phone or TV, and personal comfort items.
Medicaid Certified: Nursing Homes by State
CMS Care Compare lists 14,151 nursing homes in this group (medicaid certified) across 52 states and territories, data from August 2026. Pick a state for its nursing homes, cities and senior care rules.
How a Spouse at Home Is Protected
Congress added the spousal impoverishment rules in 1988 so that a husband or wife living at home isn’t left without money when the other spouse enters a nursing home.
Assets. When one spouse applies, the state adds up the couple’s countable assets. The spouse at home (the “community spouse”) keeps a protected share, the Community Spouse Resource Allowance. For 2026 it’s at least $32,532 and no more than $162,660, and each state sets its own figure within that range. The applicant then has to be under the state’s own limit, usually $2,000.
Income. The community spouse keeps his or her own income. If it’s below the state’s minimum monthly allowance, $2,705 in most states from July 1, 2026, part of the applicant’s income can go to the spouse to make up the difference, up to $4,066.50 a month.
The home. A state can’t place a lien on the home while the spouse lives there, and it can’t recover from the estate while the spouse is alive.
These rules are complex, and a mistake can cost months of coverage. The legal and financial planning guide explains powers of attorney and the documents to gather. An elder law attorney or your state’s legal aid program for older adults can review your situation.
The Medicaid Look-Back Period and Transfer Penalties
When your parent applies for nursing home Medicaid, the state reviews every transfer of assets in the 60 months before the application date. This is set in federal law, section 1917 of the Social Security Act.
What it catches. Gifts and sales for less than fair value: money given to children or grandchildren, a house deeded to a relative, or property sold for far less than it’s worth.
What it costs. For each such transfer, the state imposes a penalty: months when Medicaid won’t pay for nursing home care. The number of months equals the value given away divided by the average monthly private-pay cost of a nursing home in the state. The penalty doesn’t start until your parent is in the nursing home, has applied and would otherwise qualify. That timing is what makes it so hard on families: your parent needs care, and no one is paying for it.
Exceptions in the law. Transfers aren’t penalized when, for example:
- the home goes to a spouse, a child under 21, or a child who is blind or disabled;
- the home goes to a son or daughter who lived there for at least two years before the parent entered the nursing home and gave care that kept the parent at home;
- assets go to a spouse, or to a trust for the sole benefit of a blind or disabled child;
- the family shows the transfer was made for another purpose or the assets are returned;
- the state grants an undue hardship waiver.
Keep records of every large payment, and expect the state to ask about them. Spending your parent’s money on your parent’s own care and bills at fair value isn’t a transfer for less than fair market value. If any large gifts were made in the last five years, talk to an elder law attorney before applying.
Estate Recovery: What Medicaid Can Reclaim After Death
For anyone who was 55 or older when Medicaid paid for nursing home care, home and community-based services or related hospital and drug costs, federal law requires the state to seek repayment from the person’s estate after death.
Key protections, from Medicaid.gov:
- No recovery while a surviving spouse is alive, or while there is a surviving child under 21 or a blind or disabled child of any age.
- States must offer a waiver when recovery would cause undue hardship.
- A state may place a lien on the home of a resident who isn’t expected to return home, but not while a spouse, a child under 21, a blind or disabled child, or a sibling with an ownership share lives there. The lien must be removed if the resident goes home.
What counts as the estate varies by state. Federal law requires states to include property that passes through probate and lets them reach other assets, such as jointly owned property or a living trust. Your state Medicaid agency’s estate recovery office can explain its rules.
How to Apply for Medicaid Nursing Home Coverage
- Ask for a level-of-care assessment. The hospital discharge planner or nursing home social worker can start it.
- Gather records. Collect ID, proof of income, five years of bank and investment statements, deeds, life insurance policies, and any long-term care insurance policy.
- Apply through your state Medicaid agency. Many states take applications online, by phone or at a county office. The nursing home’s business office often helps.
- Answer requests quickly. Missing documents are the most common cause of delay.
- Ask about coverage dates. Ask the caseworker how far back coverage can start once your parent is approved.
- Appeal a denial. The denial letter explains how to request a fair hearing and the deadline.
While you wait, keep paying the nursing home what your parent can from income, and ask the business office to note that an application is pending. For local help, the Eldercare Locator (1-800-677-1116) connects you with your local Area Agency on Aging.
Other Ways to Pay and Where to Go Next
Medicaid works alongside other payers. A short skilled stay may come first under Medicare’s skilled nursing benefit. Veterans and surviving spouses may qualify for VA long-term care and Aid and Attendance. A long-term care insurance policy can pay first, and in states with partnership programs it can protect extra assets from the Medicaid limit. The guide to paying for a nursing home puts all the options in order.
If your parent would rather stay at home or move to assisted living, ask the state about Medicaid waivers for home care and assisted living. And when you’re choosing a home, the nursing home checklist and the nursing home comparison tool help you compare staffing, inspections and star ratings among Medicaid-certified homes.
Frequently Asked Questions
Does My Parent's House Count Against the Medicaid Asset Limit?
States treat the home separately from savings, within a federal home equity limit that for 2026 falls between $752,000 and $1,130,000, depending on the state. Tennessee, for example, says the home where you live doesn't count toward its $2,000 limit. After death, the state may seek repayment from the estate, which can include the home, unless a spouse or a protected child survives.
Can a Nursing Home Evict My Parent When Private Money Runs Out?
If the home is Medicaid certified, Medicaid.gov says your parent can usually stay in the same nursing home once Medicaid starts paying, without moving. If the home isn't Medicaid certified, your parent would have to move to one that is. Ask before admission whether the home participates in Medicaid.
Do I Have to Promise to Pay When My Parent Is Admitted?
No. Federal rules at 42 CFR 483.15 bar a nursing home from requiring a family member or other third party to promise payment as a condition of admission or continued stay. The home may ask a representative who has legal access to your parent's income to sign a contract to pay from your parent's money, without personal financial liability. Read the admission agreement carefully before signing.
How Long Does a Medicaid Nursing Home Application Take?
It varies by state and by how quickly documents arrive. States ask for up to five years of financial records because of the look-back rule, so gathering bank statements early is the most useful step you can take. Your state Medicaid agency can tell you its current processing time.
Does Medicaid Pay for Assisted Living?
Medicaid doesn't pay assisted living rent, but many states pay for care services in assisted living through home and community-based waivers, which can have waiting lists. The Medicaid waivers guide explains how they work.
What Is the Personal Needs Allowance?
It's the part of monthly income a Medicaid nursing home resident keeps for personal items. Federal rules set it at no less than $30 a month, and states set their own amount, such as $75 in Texas and $160 in Florida in 2026. The rest of the resident's income, after other allowed deductions, goes toward the cost of care.
More on Paying for Care
- Medicare and Nursing HomesSkilled nursing facility coverage, the 3-day stay rule and costs
- Medicaid WaiversHome and community-based services waivers by state
- VA Long-Term CareVA nursing home care, state veterans homes and pension benefits
- Long-Term Care InsuranceWhat policies cover, partnership programs and alternatives
- Paying for a Nursing HomeMedicare, Medicaid, VA, insurance and private pay compared
- Memory CareSecured dementia care in assisted living and nursing homes, state rules and how to pay
This guide explains long-term care in plain language from official sources. It isn't medical, legal or financial advice; a doctor, your state Medicaid agency or an elder law attorney can advise on your situation.
Sources
- Medicaid.gov: 2026 SSI and spousal impoverishment standards (CMCS Informational Bulletin, April 27, 2026)
- Medicaid.gov: Spousal impoverishment and post-eligibility treatment of income
- Medicaid.gov: Nursing facilities
- Medicaid.gov: Estate recovery
- eCFR: 42 CFR 483.15, admission, transfer and discharge rights
- SSA.gov: Social Security Act section 1917 (transfers of assets and estate recovery)
- Texas HHS: Medicaid budget reference chart (MEPD handbook)
- Pennsylvania DHS: Medicaid payment for long-term care
- CMS Provider Data Catalog: Nursing Home Provider Information (August 2026)