Does Medicaid pay for nursing home care when you need help? Yes, Medicaid covers nursing home costs for people who qualify today. You might worry about paying for long-term care expenses. Nursing home costs reach approximately $285 daily in 2025 and 2026. Your family may struggle to afford these high monthly bills.Â
Medicaid helps by paying 100% of your nursing home expenses. You must meet specific requirements to receive this assistance, however. Your income must be under $2,001 per month. Your savings must be very low to qualify for benefits. This guide provides a comprehensive explanation of Medicaid nursing home eligibility income limits.Â
You will learn how to qualify for Medicaid nursing home care. We will show you what expenses Medicaid covers for you. You will understand the differences between Medicare and Medicaid benefits. We also explain state-by-state rules that directly affect your eligibility. You will find step-by-step application instructions to help you obtain coverage successfully.
Table of Contents
What is Medicaid Government Program, and How Does it work?
Medicaid provides health coverage to 7.2 million low-income seniors today. Your state and federal governments collaborate to administer Medicaid. You can receive free healthcare if you meet the income requirements.
Medicaid differs significantly from regular health insurance in several key ways. You do not pay monthly premiums for Medicaid coverage ever. Your state decides who can get Medicaid benefits for care. Each state has different rules about who qualifies for help.
Understanding Medicaid Basic Program Requirements and Benefits
The Centers for Medicare and Medicaid Services implements laws from Congress. Your state follows federal guidelines for minimum Medicaid program standards. States can expand coverage beyond minimum federal requirements for residents. Please verify your state’s specific requirements before submitting your application.
Medicaid versus Medicare: Key Differences for Nursing Home Coverage
Many people confuse Medicaid with the Medicare program for seniors completely. Medicare helps people over sixty-five years old pay medical bills. You receive Medicare based on your age, not your income level. Medicaid helps people with very low incomes get healthcare coverage. You can have both Medicare and Medicaid simultaneously.
What are Nursing Homes and When Do You Need One
Nursing facilities provide three types of services through Medicaid certification. Nursing homes offer 24-hour care for individuals who require assistance. You might need a nursing home if you cannot live safely alone. Your doctor must determine that you require nursing home-level care.
Types of Care Services Available in Nursing Homes
Nursing homes primarily provide three types of services for residents:
- Skilled Nursing Care: Medical treatments from trained nursesÂ
- Rehabilitation Services: Help getting better after illness or injury
- Custodial Care: Help with daily activities like bathing and eating
When Nursing Home Care Becomes Necessary for Your Health
You may require nursing home care for several health-related reasons. Memory problems can make living alone unsafe for you completely. Physical disabilities may require constant medical supervision and daily care. Recovery from surgery or illness often requires skilled nursing assistance.
Does Medicaid Cover Nursing Home Room and Board CompletelyÂ
Yes, Medicaid covers your nursing home costs when you qualify. You receive 100% coverage for all approved nursing home services. Medicaid pays the nursing home directly for your care costs.
What Nursing Home Expenses Does Medicaid Cover for You
Medicaid covers most nursing home costs for qualified residents:
| Covered Services | What You Get |
| Room and board | Semi-private room and meals |
| Medical care | Doctor visits and nursing services |
| Personal care | Help with bathing, dressing, and eating |
| Medications | Prescription drugs and medical supplies |
| Therapy services | Physical, occupational, and speech therapy |
| Social services | Discharge planning and counseling |
Medicaid Personal Needs Allowance Nursing Home: Explanation for Each State
You maintain a small personal needs allowance, ranging from $30 to $200 monthly. Your Personal Needs Allowance does not need to be spent entirely each month. California provides a monthly personal needs allowance of thirty-five dollars.
| State | Personal Needs Allowance 2025-2026 | Income Limit |
| Alabama | $50 monthly | $2,901 |
| Alaska | $100 monthly | $2,901 |
| Arizona | $100 monthly | $2,901 |
| Arkansas | $50 monthly | $2,901 |
| California | $500 monthly | $2,901 |
| Colorado | $60 monthly | $2,901 |
| Connecticut | $60 monthly | $2,901 |
| Delaware | $50 monthly | $2,901 |
| Florida | $160 monthly | $2,901 |
| Georgia | $50 monthly | $2,901 |
| Hawaii | $30 monthly | $2,901 |
| Idaho | $60 monthly | $2,901 |
| Illinois | $30 monthly | $2,901 |
| Indiana | $50 monthly | $2,901 |
| Iowa | $50 monthly | $2,901 |
| Kansas | $60 monthly | $2,901 |
| Kentucky | $50 monthly | $2,901 |
| Louisiana | $38 monthly | $2,901 |
| Maine | $50 monthly | $2,901 |
| Maryland | $50 monthly | $2,901 |
| Massachusetts | $72 monthly | $2,901 |
| Michigan | $60 monthly | $2,901 |
| Minnesota | $100 monthly | $2,901 |
| Mississippi | $54 monthly | $2,901 |
| Missouri | $30 monthly | $2,901 |
| Montana | $100 monthly | $2,901 |
| Nebraska | $55 monthly | $2,901 |
| Nevada | $35 monthly | $2,901 |
| New Hampshire | $75 monthly | $2,901 |
| New Jersey | $50 monthly | $2,901 |
| New Mexico | $60 monthly | $2,901 |
| New York | $50 monthly | $2,901 |
| North Carolina | $30 monthly | $2,901 |
| North Dakota | $60 monthly | $2,901 |
| Ohio | $44 monthly | $2,901 |
| Oklahoma | $60 monthly | $2,901 |
| Oregon | $100 monthly | $2,901 |
| Pennsylvania | $55 monthly | $2,901 |
| Rhode Island | $55 monthly | $2,901 |
| South Carolina | $50 monthly | $2,901 |
| South Dakota | $100 monthly | $2,901 |
| Tennessee | $50 monthly | $2,901 |
| Texas | $60 monthly | $2,901 |
| Utah | $45 monthly | $2,901 |
| Vermont | $58 monthly | $2,901 |
| Virginia | $40 monthly | $2,901 |
| Washington | $62 monthly | $2,901 |
| West Virginia | $40 monthly | $2,901 |
| Wisconsin | $58 monthly | $2,901 |
| Wyoming | $100 monthly | $2,901 |
Monthly Maintenance Needs Allowance for Spouses
Congress enacted provisions to prevent spousal impoverishment in nineteen eighty-eight. Your spouse can keep up to $3,948 monthly in 2025. The Monthly Maintenance Needs Allowance provides your spouse with complete financial protection. Your spouse can retain up to fifty percent of the couple’s assets, valued at up to $157,920.
How to Qualify for Medicaid Nursing Home Care: Complete Process
You must have a monthly income of no more than $2,901. You must meet both financial and medical requirements simultaneously. Your income and savings are likely to be very low. You also need medical proof of nursing home care needs.
Financial Eligibility Requirements for 2025 and 2026
Your monthly income must be under $2,001. You can only have up to $2,000 in countable assets in 2025. Some things do not count toward your asset limit:
- Your primary home if your spouse lives thereÂ
- One car for transportation needsÂ
- Personal belongings and furniture itemsÂ
- Burial plots and funeral funds up to one thousand five hundred dollars
Medical Eligibility and Level of Care Requirements
A doctor must thoroughly evaluate your health and care needs. You need help with daily activities, such as bathing or dressing. Memory problems that make living alone dangerous also qualify you. Your state uses assessment tools to determine medical eligibility requirements.
Medicaid Nursing Home Spend Down Rules Complete Strategy
You cannot qualify for Medicaid if your monthly income exceeds $2,901. Spend-down rules allow you to pay medical bills first. You subtract medical expenses from your monthly income amount. If the remaining amount meets limits, you can qualify successfully.
Comprehensive State-by-State Variations in Medicaid Nursing Home Coverage for Each State
Each state has different Medicaid rules and income limits. You should carefully review your state’s specific requirements. Some states are more generous with eligibility than others.
Income Limits Across Each State: Complete Comparison Table
In most states, the monthly income limit is $2,901. Illinois has a monthly limit of $1,304. California has no income limit for Nursing Home Medicaid.
| State | 2025-2026 Income Limit | Asset Limit | Special Rules |
| Alabama | $2,901 | $2,000 | Standard federal limit |
| Alaska | $2,901 | $2,000 | Enhanced personal needs allowance |
| Arizona | $2,901 | $2,000 | ALTCS waiver program |
| Arkansas | $2,901 | $2,000 | Standard federal limit |
| California | No income limit | $2,000 | Medically needy program available |
| Colorado | $2,901 | $2,000 | Standard federal limit |
| Connecticut | $2,901 | $2,000 | Enhanced spousal protections |
| Delaware | $2,901 | $2,000 | Standard federal limit |
| Florida | $2,901 | $2,000 | Highest personal needs allowance |
| Georgia | $2,901 | $2,000 | Standard federal limit |
| Hawaii | $1,304 | $2,000 | Medically needy program |
| Idaho | $2,901 | $2,000 | Standard federal limit |
| Illinois | $1,304 | $2,000 | Medically needy program |
| Indiana | $2,901 | $2,000 | Standard federal limit |
| Iowa | $2,901 | $2,000 | Standard federal limit |
| Kansas | $2,901 | $2,000 | Standard federal limit |
| Kentucky | $2,901 | $2,000 | Standard federal limit |
| Louisiana | $2,901 | $2,000 | Standard federal limit |
| Maine | $2,901 | $2,000 | Standard federal limit |
| Maryland | $2,901 | $2,000 | Standard federal limit |
| Massachusetts | $2,901 | $2,000 | Enhanced benefits |
| Michigan | $2,901 | $2,000 | Standard federal limit |
| Minnesota | $1,305 | $2,000 | Higher asset limits |
| Mississippi | $2,901 | $2,000 | Standard federal limit |
| Missouri | $2,901 | $2,000 | Standard federal limit |
| Montana | $2,901 | $2,000 | Standard federal limit |
| Nebraska | $2,901 | $2,000 | Standard federal limit |
| Nevada | $2,901 | $2,000 | Standard federal limit |
| New Hampshire | $2,901 | $2,000 | Standard federal limit |
| New Jersey | $2,901 | $2,000 | Enhanced spousal protections |
| New Mexico | $2,901 | $2,000 | Standard federal limit |
| New York | $2,901 | $2,000 | Enhanced spousal protections |
| North Carolina | $2,901 | $2,000 | Standard federal limit |
| North Dakota | $2,901 | $2,000 | Standard federal limit |
| Ohio | $2,901 | $2,000 | Standard federal limit |
| Oklahoma | $2,901 | $2,000 | Standard federal limit |
| Oregon | $2,901 | $2,000 | Standard federal limit |
| Pennsylvania | $2,901 | $2,000 | Standard federal limit |
| Rhode Island | $2,901 | $2,000 | Standard federal limit |
| South Carolina | $2,901 | $2,000 | Standard federal limit |
| South Dakota | $2,901 | $2,000 | Standard federal limit |
| Tennessee | $2,901 | $2,000 | Standard federal limit |
| Texas | $2,901 | $2,000 | Standard federal limit |
| Utah | $2,901 | $2,000 | Standard federal limit |
| Vermont | $2,901 | $2,000 | Standard federal limit |
| Virginia | $2,901 | $2,000 | Standard federal limit |
| Washington | $2,901 | $2,000 | Standard federal limit |
| West Virginia | $2,901 | $2,000 | Standard federal limit |
| Wisconsin | $2,901 | $2,000 | Standard federal limit |
| Wyoming | $2,901 | $2,000 | Standard federal limit |
Medically Needy States versus Regular Programs
Some states have medically needy Medicaid programs available today. You can qualify even with a higher income in medically needy states. You spend down excess income on medical bills each month.
Do All Nursing Homes Accept Medicaid Patients
No, not all nursing homes accept Medicaid patients today. Many facilities prefer private paying residents over Medicaid patients. Private patients pay about thirty percent more than Medicaid rates.
Finding Medicaid-Accepting Nursing Homes
You need to search carefully for facilities that currently accept Medicaid. Contact your state Medicaid office for a list of approved facilities. Contact each facility directly to inquire about its current Medicaid bed availability. Some facilities have waiting lists for Medicaid beds only.
Why Some Nursing Homes Avoid Medicaid
Medicaid pays nursing homes less money than private patients. Private patients pay approximately $285 daily. Medicaid only pays facilities roughly $199 per day. Lower payments can cause some facilities to limit Medicaid admissions completely.
Complete Step-by-Step Medicaid Application Journey Process
Getting Medicaid for nursing home care takes several steps. You must gather numerous documents and complete the forms accurately. The process typically takes between forty-five to ninety days in total.
Step One: Gather Required Documents
You need to collect essential papers before applying:
- Social Security cards and birth certificatesÂ
- Bank statements from the last five yearsÂ
- Income records, including Social Security and pensionsÂ
- Property deeds and vehicle titlesÂ
- Medical records proving your care needs
Step Two: Complete the Application Process Detailed Instructions
Contact your state Medicaid office to get application forms. Complete all forms accurately and submit them for approval. Submit your application with all required documents attached. Respond promptly to any requests for additional information that may be needed.
Step Three: Medical Assessment and Approval Complete Process
A healthcare professional will thoroughly evaluate your care needs. You must demonstrate you need nursing home-level care. Your state will review both financial and medical qualifications. You will receive a notification of approval or denial by mail.
Home and Community-Based Services versus Nursing Home Medicaid
You might prefer staying home instead of nursing home care. Medicaid offers Home and Community-Based Services waiver programs. Home and Community-Based Services let you receive care at home.
What Home and Community-Based Services Waiver Programs Provide Complete Benefits
Home and Community-Based Services allow millions of Medicaid beneficiaries to receive services:
- Personal care assistants for daily living helpÂ
- Adult day care programs for socializationÂ
- Home modifications for safety and accessibilityÂ
- Transportation to medical appointments and activities
Comparing Home and Community-Based Services versus Nursing Home Medicaid Costs
Home and Community-Based Services programs usually cost less than nursing home care. Your state might prefer Home and Community-Based Services over expensive nursing home placement.Â
You must still meet medical eligibility for Home and Community-Based Services programs. Waiting lists for Home and Community-Based Services programs exist in many states.
Frequently Asked Questions
How do nursing homes get paid by Medicaid?
Medicaid pays nursing homes directly using state-established daily rates. You contribute most of your monthly income to care for them. Medicaid pays the remaining balance to cover all costs.
Will Medicaid pay for nursing homes if I own a home?
Yes, you can keep your home and still be eligible to qualify. Your house does not count as an asset if your spouse lives there. Your state may place a lien on your home, though.
Who pays for a nursing home if you have no money?
Medicaid pays for your nursing home care if you qualify. To be eligible for coverage, you must meet specific income and asset limits. Apply for Medicaid as soon as you need nursing home care.
What does Medicaid not pay for?
Medicaid does not cover the cost of private rooms or luxury amenities. You pay separately for telephone, television, and premium services. Medicaid covers all medically necessary care and basic room needs.
Conclusion
Does Medicaid pay for nursing home care? Yes, Medicaid does cover nursing home care when you meet the eligibility requirements. Your income must be under $2,001 per month. You can only have up to $2,000 in countable assets. Medicaid covers 100% of approved nursing home costs.Â
You maintain a small personal allowance to cover your monthly expenses. The application process can be time-consuming, so it’s best to start planning early. Consider all long-term care options before choosing nursing home placement.Â
Home and Community-Based Services programs may allow you to stay at home with support. Professional Medicaid planning can help you navigate complex rules successfully.
