California Nursing Home Medicaid pays for a nursing home once Medicare’s short rehabilitation benefit runs out — but only after the family clears an income test, an asset test and a level-of-care assessment. This California nursing home medicaid guide gives the 2026 figures, what the spouse at home is allowed to keep, how the five-year look-back works, and where in California the application actually goes.
Every dollar figure below comes from the state Medicaid agency, CMS or the statute cited, and each resets on its own calendar. Where California has not published a current figure we say so instead of guessing.
In This California Nursing Home Medicaid Guide:
California Nursing Home Medicaid at a Glance (2026)
| Program | California’s Medicaid program is called Medi-Cal, and nursing home coverage is administered as Long-Term Care (LTC) Medi-Cal. Families and county workers also refer to it simply as “Medi-Cal for long-term care” or “LTC Medi-Cal,” and it covers care in a licensed nursing facility that lasts, or is expected to last, at least a full calendar month after the month of admission. The Department of Health Care Services (DHCS) runs the program statewide, while the 58 counties handle eligibility. |
| 2026 income limit (single applicant) | No income limit; resident keeps $35/month, the rest goes to the cost of care |
| 2026 asset limit (single applicant) | $130,000 |
| Spouse at home may keep (assets) | $32,532 to $162,660 |
| Spouse at home income floor | $2,705 to $4,066.50 per month |
| Look-back period | 30 months |
| Penalty divisor | $14,440/month (2026) (confirm with The application is taken by your county human services, social services, or public social services agency — the county Medi-Cal eligibility office where the applicant lives. Many nursing facilities keep applications on hand and have a social worker or admissions coordinator who helps families file. DHCS publishes a county-by-county contact list, and the statewide Medi-Cal Member Helpline is 1-800-541-5555. The DHCS Medi-Cal Eligibility Division can be reached at (916) 552-9200 for policy questions, though it does not process individual applications.) |
| Home equity limit (no spouse at home) | no equity cap (confirm with The application is taken by your county human services, social services, or public social services agency — the county Medi-Cal eligibility office where the applicant lives. Many nursing facilities keep applications on hand and have a social worker or admissions coordinator who helps families file. DHCS publishes a county-by-county contact list, and the statewide Medi-Cal Member Helpline is 1-800-541-5555. The DHCS Medi-Cal Eligibility Division can be reached at (916) 552-9200 for policy questions, though it does not process individual applications.) |
| Over the income limit? | Medically-needy spend-down — no Miller trust |
California Nursing Home Medicaid Income and Asset Limits
Two tests, both applied to the person entering the facility. The income test looks at gross monthly income from every source — Social Security, pensions, IRA withdrawals, annuities, rent. The asset test counts what can be turned into cash: bank accounts, investments, retirement accounts in most states, and any property other than the home.
California is a medically-needy state. Being over the California nursing home medicaid income figure does not end the application: the excess is spent down on the cost of care each month, and the nursing home bill itself usually absorbs it. No Miller trust is needed.
California reinstated an asset test for non-MAGI Medi-Cal, including long-term care, at the start of 2026, so the older exemption rules apply again. The home the applicant lives in — or intends to return to — is generally not counted, and neither is one vehicle. Household goods and personal effects such as furniture, clothing and a television are excluded, as are prepaid irrevocable burial arrangements and burial plots.
Second homes, land the person does not live on, extra vehicles and ordinary bank balances are counted. Specific limits and values: UNVERIFIED.
California does not require a qualified income trust, Miller trust, or income-only trust for nursing home Medi-Cal. There is no hard income ceiling that disqualifies a long-term care applicant. Instead, California uses a medically needy share-of-cost approach: countable monthly income above the maintenance need level becomes the resident’s monthly share of cost, paid to the nursing facility, and Medi-Cal pays the remaining cost of care.
A personal needs allowance, health insurance premiums, and any spousal or family allowance are deducted first. Amounts: UNVERIFIED.
What the Spouse at Home Keeps Under California Nursing Home Medicaid
Federal spousal impoverishment rules stop California nursing home medicaid from bankrupting the husband or wife who stays home. The at-home spouse keeps a protected share of the couple’s assets — between $32,532 and $162,660 in 2026 — and is guaranteed a monthly income floor of at least $2,705, rising to $4,066.50 when housing costs are high. The house is fully exempt while the spouse lives in it.
California applies the federal spousal impoverishment protections so the husband or wife remaining at home is not left destitute, allowing a resource allowance for the community spouse and a monthly maintenance income allowance diverted from the nursing home spouse’s income. California also extends these spousal protections to married applicants receiving home and community-based services, not just institutional care.
DHCS changed how counties handle community spouse resource determinations during the asset-limit elimination, so ask the county worker which rules govern your start date. All dollar allowances: UNVERIFIED.
The asset snapshot is taken on the first day of the continuous stay, not the application date. Families who spend down before asking for a resource assessment often spend money the spouse was entitled to keep.
The Look-Back Rule and Transfer Penalties
California reviews every transfer made in the 30 months before the application. Money or property given away, or sold for less than it was worth, is added up and divided by the state’s penalty divisor — its average private-pay nursing home cost — to produce a period during which California nursing home medicaid will not pay.
The divisor in California is $14,440/month (2026) (confirm with The application is taken by your county human services, social services, or public social services agency — the county Medi-Cal eligibility office where the applicant lives. Many nursing facilities keep applications on hand and have a social worker or admissions coordinator who helps families file. DHCS publishes a county-by-county contact list, and the statewide Medi-Cal Member Helpline is 1-800-541-5555.
The DHCS Medi-Cal Eligibility Division can be reached at (916) 552-9200 for policy questions, though it does not process individual applications.).
California is phasing a 30-month look-back back in from July 1, 2026 (reaches 30 months for applications on/after 7/1/2028); transfers made in 2024-2025 are not reviewed. The IRS annual gift exclusion has no bearing here: a gift that is tax-free can still trigger a Medicaid penalty. Transfers to a spouse, to a disabled child, or of the home to a child who lived there and provided care for two years are the main exceptions.
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How to Apply for California Nursing Home Medicaid
Where: The application is taken by your county human services, social services, or public social services agency — the county Medi-Cal eligibility office where the applicant lives. Many nursing facilities keep applications on hand and have a social worker or admissions coordinator who helps families file. DHCS publishes a county-by-county contact list, and the statewide Medi-Cal Member Helpline is 1-800-541-5555. The DHCS Medi-Cal Eligibility Division can be reached at (916) 552-9200 for policy questions, though it does not process individual applications. — start the application.
California decides medical need through a nursing facility level-of-care determination made on a Treatment Authorization Request (TAR), submitted by the facility on the Long Term Care TAR (form 20-1) and adjudicated by DHCS medical and nursing consultants. California recognizes Nursing Facility Level A and Nursing Facility Level B, with Level B covering skilled nursing needs and Level A covering protective, intermediate-level care.
Reviewers look at diagnoses, physician orders, dependency in activities of daily living such as bathing, dressing, transferring, toileting and eating, and the need for ongoing nursing observation.
Bring five years of bank statements, deeds, vehicle titles, insurance policies, the Medicare and Social Security cards, and any trust or power of attorney documents. Missing paperwork is the most common reason a California nursing home medicaid decision is delayed.
While the Application Is Pending
While the application is pending, the nursing facility still provides care and typically bills the resident privately or holds the account, then rebills Medi-Cal retroactively once eligibility is approved. California allows applicants to request retroactive coverage for months before the application using the Statement of Facts for Retroactive Coverage/Restoration (form MC 210 A), which the county completes from information you supply.
Approval is issued through a written Notice of Action from the county. Typical decision time in weeks: UNVERIFIED.
After approval, nearly all of the resident’s income goes to the facility each month as the patient share, minus a small personal needs allowance, health insurance premiums and the spouse’s allowance.
Denials, Appeals and What Comes After
The most frequent problems are not denials on the merits but delays from missing verifications — bank statements, property deeds, life insurance policies, income proof, trust documents, and records of past transfers that the county requests. Applications are also denied or delayed for uncompensated asset transfers, unreported second properties or accounts, missing citizenship or residency proof, and TARs that fail to document nursing facility level of care.
Any denial, share-of-cost figure, or termination can be appealed by requesting a State Hearing from the California Department of Social Services at https://www.cdss.ca.gov/hearing-requests.
One more thing families should know before they file: after the resident’s death, the state may seek repayment from the estate. That process — what it can reach and the exemptions — is covered in our guide to California Medicaid estate recovery.
A Realistic California Nursing Home Medicaid Timeline
Week one: the hospital or family calls the Medicaid office for the level-of-care assessment and starts gathering five years of statements. Weeks two to four: the assessment is done and the financial application is filed, usually with the facility’s admissions office helping. Weeks six to twelve: the caseworker verifies accounts and may ask for more documents; answer within the deadline on each request or the clock resets.
Approval, when it comes, is retroactive to the eligibility date, which is why filing early is the single most valuable thing a family can do.
Where to Get Help Free
Two free doors exist in every state: the California SHIP counselor for the Medicare side and the state’s Aging and Disability Resource Center for the Medicaid side. Neither sells anything. For a California nursing home medicaid question involving a house, a spouse at home or a recent gift, a local elder law attorney or legal aid office is the next call.
Key Takeaways: California Nursing Home Medicaid
- Two tests, not one: California nursing home medicaid checks income and assets separately, and passing one does not excuse the other.
- The spouse is protected: the at-home spouse keeps a share of assets and an income floor under California nursing home medicaid before anything is spent down.
- The look-back is five years: any gift inside it is divided by the divisor and becomes months without California nursing home medicaid coverage.
- The home usually does not count: while a spouse lives there, the house is exempt from the California nursing home medicaid asset test.
- Apply as Medicaid pending: most facilities admit while California nursing home medicaid is decided and the state pays back to the eligibility date.
- Assessment first: the level-of-care evaluation is what starts the California nursing home medicaid clock, so request it on day one.
- Retirement accounts often count: IRAs and 401(k)s are countable in most states under California nursing home medicaid unless in payout status.
- Income trust or spend-down: whether an over-income applicant needs a Miller trust is the first California nursing home medicaid question to settle.
- The resource snapshot matters: California nursing home medicaid measures the couple’s assets on the day the stay began, not the day you apply.
Official Sources
- California’s Medicaid program is called Medi-Cal, and nursing home coverage is administered as Long-Term Care (LTC) Medi-Cal. Families and county workers also refer to it simply as “Medi-Cal for long-term care” or “LTC Medi-Cal,” and it covers care in a licensed nursing facility that lasts, or is expected to last, at least a full calendar month after the month of admission. The Department of Health Care Services (DHCS) runs the program statewide, while the 58 counties handle eligibility. — California Medicaid: https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/medi-cal-information/ is the DHCS page covering Medi-Cal long-term care information and alternatives. For the 2026 asset rules that now affect nursing home applicants, DHCS maintains an Asset Limit Frequently Asked Questions page at https://www.dhcs.ca.gov/Medi-Cal/Pages/Help/asset-limits-faqs.aspx. County-specific application contacts are at https://www.dhcs.ca.gov/services/medi-cal/Pages/Contacts.aspx.
- The application is taken by your county human services, social services, or public social services agency — the county Medi-Cal eligibility office where the applicant lives. Many nursing facilities keep applications on hand and have a social worker or admissions coordinator who helps families file. DHCS publishes a county-by-county contact list, and the statewide Medi-Cal Member Helpline is 1-800-541-5555. The DHCS Medi-Cal Eligibility Division can be reached at (916) 552-9200 for policy questions, though it does not process individual applications.: https://www.dhcs.ca.gov/services/medi-cal/Pages/Contacts.aspx is the DHCS page listing every county Medi-Cal office where a long-term care application is started. General member help and application guidance is at https://www.dhcs.ca.gov/medi-cal/help/. The exact statewide URL for downloading the paper long-term care Statement of Facts packet is UNVERIFIED; request the current forms from the county office directly.
- Medicaid.gov spousal impoverishment standards: medicaid.gov
- Medicare.gov Medicare Savings Programs: medicare.gov
This California nursing home medicaid guide was checked against the state Medicaid agency, CMS and the statute cited above in September 2026. Figures reset on their own calendars (most on January 1); if a number here disagrees with a notice you received, the notice wins — and please tell us. This page is general information, not legal, financial or medical advice.