Indiana Nursing Home Medicaid 2026: Limits, Spouse Rules and How to Apply

Indiana 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 Indiana 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 Indiana 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 Indiana has not published a current figure we say so instead of guessing.

Indiana Nursing Home Medicaid at a Glance (2026)

Indiana 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.

Indiana is an income-cap state. If the applicant’s gross monthly income is over the Indiana nursing home medicaid limit by even a dollar, the application is denied unless a qualified income trust (a Miller trust) is set up first and funded every month.

Indiana follows the standard categories of resources that are not counted. The home is generally excluded while the applicant intends to return to it, or while a spouse or certain dependent relatives still live there, subject to an equity ceiling that is set separately. One vehicle used for the household’s transportation is normally excluded, as are household goods, furniture, and personal effects such as clothing and a wedding ring.

Irrevocable prepaid funeral and burial arrangements and designated burial spaces are also excluded when properly structured.

Indiana is an income-cap state for institutional Medicaid, so an applicant whose income exceeds the special income limit must establish a Qualified Income Trust, which Indiana officially calls a Miller Trust. The FSSA Office of Medicaid Policy and Planning publishes instructions and a model at https://www.in.gov/fssa/ompp/miller-trust.

The trust must be funded solely with the applicant’s own income, and Indiana must be named to receive remaining funds up to what Medicaid paid. Trust money may only be used for the personal needs allowance, the community spouse allowance, and medical costs.

What the Spouse at Home Keeps Under Indiana Nursing Home Medicaid

Federal spousal impoverishment rules stop Indiana 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.

Indiana applies the federal spousal impoverishment protections and does not add unusual state twists. The DFR performs a resource assessment that takes a “snapshot” of the couple’s countable assets as of the first continuous institutionalization, and from that snapshot it calculates the Community Spouse Resource Allowance the at-home spouse may keep. A monthly maintenance needs allowance can also shift income from the nursing home spouse to the community spouse.

Indiana additionally runs the Indiana Long Term Care Insurance Program, whose partnership policies allow extra asset protection.

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

Indiana reviews every transfer made in the 60 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 Indiana nursing home medicaid will not pay.

The divisor in Indiana is not published here yet — confirm with The application is taken by the Indiana Family and Social Services Administration’s Division of Family Resources, known as the DFR, which determines Medicaid eligibility and has offices in all ninety-two counties. Families can call the DFR benefits line at 1-800-403-0864 to apply by phone, ask questions, or find the nearest office.

The nursing facility’s business office or admissions coordinator will usually help gather documents, but the DFR, not the facility, makes the eligibility decision..

60 months, federal standard. 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.

How to Apply for Indiana Nursing Home Medicaid

Where: The application is taken by the Indiana Family and Social Services Administration’s Division of Family Resources, known as the DFR, which determines Medicaid eligibility and has offices in all ninety-two counties. Families can call the DFR benefits line at 1-800-403-0864 to apply by phone, ask questions, or find the nearest office. The nursing facility’s business office or admissions coordinator will usually help gather documents, but the DFR, not the facility, makes the eligibility decision. — start the application.

Indiana requires a nursing facility level of care determination, usually shortened to NFLOC. It is handled through the Level of Care Assessment Referral process, and the assessment is performed by the state’s Level of Care Assessment Representative, with Area Agencies on Aging conducting on-site assessments before any denial is finalized.

The assessor looks at the person’s medical conditions, ability to handle daily activities such as bathing, dressing, eating, and moving safely, cognition, and the skilled nursing or supervision needed. Every nursing facility admission also runs through Preadmission Screening and Resident Review, known as PASRR.

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 an Indiana nursing home medicaid decision is delayed.

While the Application Is Pending

While the application is pending, the nursing home still provides care and generally bills the family privately or holds the account open, then rebills Medicaid once eligibility is approved back to the effective date. Indiana allows retroactive coverage for medical bills incurred before the application month when the person would have qualified then; the exact retroactive window is UNVERIFIED.

The DFR may issue verification requests during this period, and responding promptly is what most often keeps a case moving. Typical decision time is 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 missing or incomplete verification — bank statements, deed and title records, life insurance values, and proof of income — followed by countable resources still above the limit, unexplained transfers of money or property during the look-back review, and failing to set up or properly fund a Miller Trust when income is over the cap. Level of care denials also occur.

A denial or delay can be appealed by requesting a fair hearing before an administrative law judge at the Office of Administrative Law Proceedings.

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 Indiana Medicaid estate recovery.

A Realistic Indiana 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 Indiana SHIP counselor for the Medicare side and the state’s Aging and Disability Resource Center for the Medicaid side. Neither sells anything. For an Indiana 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.

Official Sources

• Indiana does not use a separate brand for nursing-home coverage; it is simply Indiana Medicaid, and the eligibility category families will see on paperwork is Medicaid for the Aged, Blind, and Disabled with nursing facility (institutional) status. Once approved, a resident’s nursing facility care is delivered either through Traditional Medicaid or, for most Hoosiers age sixty and older, through the managed long-term services program Indiana PathWays for Aging. The Family and Social Services Administration also uses the term “long-term care Medicaid” on its own member pages. — Indiana Medicaid: https://www.in.gov/medicaid/members/aged-blind-and-disabled/ is the best single official page for Indiana long-term care Medicaid eligibility, with https://www.in.gov/medicaid/members/apply-for-medicaid/ for the application itself and https://www.in.gov/fssa/ompp/forms-documents-and-tools/medicaid-eligibility-policy-manual/ for the full Indiana Health Coverage Program Policy Manual that caseworkers actually apply.
• The application is taken by the Indiana Family and Social Services Administration’s Division of Family Resources, known as the DFR, which determines Medicaid eligibility and has offices in all ninety-two counties. Families can call the DFR benefits line at 1-800-403-0864 to apply by phone, ask questions, or find the nearest office. The nursing facility’s business office or admissions coordinator will usually help gather documents, but the DFR, not the facility, makes the eligibility decision.: https://www.in.gov/medicaid/members/apply-for-medicaid/ is the official starting point, and the online application itself is filed through the FSSA Benefits Portal at https://fssabenefits.in.gov/bp. That same in.gov page links the paper Indiana Application for Health Coverage, which can be printed, completed, and mailed or hand-delivered to a local DFR office. Applications may also be started by telephone through the DFR number above.
• Medicaid.gov spousal impoverishment standards: medicaid.gov
• Medicare.gov Medicare Savings Programs: medicare.gov

This Indiana 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.

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