Nursing Home Medicaid Limits Master Guide

What Nursing Home Medicaid Limits Actually Decide

Nursing home Medicaid limits decide whether the state pays for a parent’s care, which in 2026 runs $9,000 to $15,000 a month in most of the country. Medicare pays for up to 100 days of rehab after a hospital stay and then stops. After that, the choices are private pay, long-term care insurance, or Medicaid — and Medicaid is the one that pays for two out of three nursing home residents.

There are two lines. The income limit is the monthly figure the applicant’s gross income must be under, or, in the states without a hard cap, the figure above which income is spent on care first. The asset limit is what the applicant may own, not counting the home, one car, and a short list of exempt items. Both are tested on the applicant alone; a spouse at home has separate protections.

Federal law sets the framework and the floors, but every state fills in the numbers. That is why the nursing home medicaid limits in Ohio are not the limits in Pennsylvania, and why the Nursing Home Medicaid by State directory exists. The table on this page gives the two facts that matter first for every state, read from each state’s own Medicaid pages.

The 2026 Federal Anchors Every State Builds On

The income cap is 300 percent of the SSI federal benefit rate: $2,982 a month in 2026. The 25 states that use it as a hard line are called income-cap states. An applicant over the line in those states is not disqualified; they need a qualified income trust, described below. The other states let the applicant spend excess income on care and qualify on what is left.

The asset limit for a single applicant is $2,000 in most states, unchanged for decades. The spouse at home keeps a community spouse resource allowance of between $32,532 and $162,660 in 2026, depending on the state’s formula, plus a monthly income allowance of at least $2,705.00 from July 2026 and up to $4,066.50.

The home is exempt while the applicant intends to return or a spouse or dependent lives there, as long as equity is under the state’s cap: $752,000 in most states, $1,130,000 in the states that elected the higher figure, and no cap at all in California. The look-back is 60 months everywhere. These are the nursing home medicaid limits set in Washington; the state table shows where each state departs from them.

The Asset Limit Is Not Always $2,000

This is the fact that national summaries get wrong most often. 15 states use a single-applicant asset figure other than $2,000, and the differences are large. Michigan’s is $9,950. Maine’s is $10,000. Illinois uses $17,500 and New York $33,038. Mississippi, Nebraska and Rhode Island use $4,000; Minnesota and North Dakota $3,000; Connecticut $1,600. Pennsylvania uses $8,000 for an applicant with income under the cap and $2,400 above it. California’s is $130,000.

A family that reads the federal standard and stops there can spend down thousands of dollars that the state would have let the parent keep. The reverse happens too: a family in a $1,600 state that plans around $2,000 gets a denial for being $300 over. The nursing home medicaid limits in the table below are the single-applicant asset figure as each state’s own agency publishes it, with the state’s source cited in the full guide.

Exempt assets are similar everywhere but not identical. The home, one vehicle, household goods, personal effects, a burial plot, a prepaid irrevocable funeral contract, and life insurance with a small face value are excluded in every state. Retirement accounts, a second vehicle, and cash-value life insurance above the exclusion count in most. The state guide lists the exceptions.

Nursing Home Medicaid Limits: All 50 States at a Glance

The table gives two facts for every state, each read from the state’s own Medicaid eligibility pages or the agency rule it cites: the 2026 asset limit for a single applicant, and whether the state uses a hard income cap that requires a qualified income trust. Every state name links to the full guide, which adds the income figure, the spouse protections, the penalty divisor, the personal-needs allowance, and the office that takes the application.

Two things stand out. First, the asset column: 35 states at $2,000, 15 states elsewhere, and the elsewhere ranges from $1,600 to $130,000. Second, the income-cap column splits the country almost in half — 25 states require the trust, 25 do not — and the split does not follow region or politics. Maine and Nebraska carry conflicting published sources on the cap question, and the table says so rather than picking one.

Income-Cap States and the Qualified Income Trust

In an income-cap state, an applicant with gross income over $2,982 a month cannot qualify — unless the excess is placed each month into a qualified income trust, often called a Miller trust. The trust is a bank account with a short legal document behind it. Income above the cap goes in; the trustee pays it out to the nursing home; the applicant is treated as under the line.

The trust is not planning, it is paperwork, but it has to exist before the application month. A family in an income-cap state that applies without one is denied, and the denial is correct. An elder law attorney sets one up for a few hundred dollars, and some state agencies provide a template. The state guide says which.

In the other states, called medically needy or spend-down states, no trust is needed. Income over the state’s medically needy line is paid toward care as a share of cost, and Medicaid pays the rest. The nursing home medicaid limits work differently in the two systems, and a family that moves a parent across a state line should check which system the new state uses before anything else.

What the Spouse at Home Keeps

When one spouse enters a nursing home and the other stays home, federal spousal impoverishment rules protect the one at home. The community spouse keeps a resource allowance — in 2026 no less than $32,532 and no more than $162,660 of the couple’s combined countable assets — and the house, one car, and the exempt items on top of that. States choose where in that range their formula lands; many use half of the couple’s assets up to the maximum, and some let the community spouse keep the maximum regardless.

The community spouse also keeps income. If the spouse’s own income is under the monthly maintenance needs allowance — $2,705.00 a month from July 2026, up to $4,066.50 where housing costs justify it — part of the nursing home spouse’s income is diverted to bring them up to it. That diversion happens before the patient liability is calculated, so it reduces what the facility receives.

The community spouse’s own assets above the allowance count against the applicant, which is the rule that surprises couples who kept separate accounts. Every dollar in either name is counted, then the allowance is carved out for the spouse at home, and the rest must be under the applicant’s limit. The state guide gives the state’s formula, because the difference between a 50 percent state and a 100 percent state can be $80,000.

The Look-Back and the Penalty Divisor

Every state looks back 60 months from the application date for gifts and transfers for less than fair value. The total of those transfers is divided by the state’s penalty divisor — the average monthly cost of a nursing home in that state, published by the agency on its own schedule — and the result is a number of months during which Medicaid will not pay, starting from the date the applicant would otherwise have qualified.

The divisor is the single figure most likely to be out of date on any national site, because each state publishes it on a different date and some publish it only in an agency manual. This page does not put it in the table for that reason; the state guide carries it where the state has published it and tells the reader which office to confirm it with where it has not.

Transfers to a spouse, to a blind or disabled child, and of the home to a caregiver child who lived there two years and kept the parent out of a facility are exempt from the penalty in every state. Everything else — the birthday checks, the car given to a grandchild, the house deeded to a daughter — is counted, and the burden is on the family to document what was a payment for value rather than a gift.

What the Resident Keeps After Approval

Once approved, nearly all of the resident’s income goes to the facility as the patient liability. The resident keeps a personal needs allowance — a small monthly amount set by the state for toiletries, haircuts and phone — plus any diversion to the community spouse, plus the cost of health insurance premiums the resident still pays. The state guide gives the allowance, because it is the figure the family sees every month.

The home stays exempt while the resident intends to return, which most states presume, but the state may place a lien on it in some circumstances once the resident is permanently institutionalized and no protected person lives there. After the resident’s death, estate recovery lets the state claim what it paid from the estate, subject to the surviving-spouse and disabled-child deferrals and the hardship waiver.

That is the part families most often learn about last. The nursing home medicaid limits get the parent in; estate recovery is the bill that comes later, and it is a different set of rules with its own exemptions. Planning that protects the house from the asset test may or may not protect it from recovery, depending on whether the state reaches only the probate estate or everything the parent had an interest in.

How to Apply, Step by Step

Gather five years of statements for every account, the deed, the vehicle title, every life insurance policy, the prepaid funeral contract, and proof of every income source. The application asks for all of it, and a missing statement is the most common reason an application stalls. Then request the level-of-care assessment, which every state requires before it will pay, and which the facility can usually arrange.

File the application with the state Medicaid office named in the state guide, or the county office where the state uses counties. Most facilities will admit or keep a resident as Medicaid pending once the application is filed and will be paid back to the eligibility date when the state approves. Get the facility’s answer in writing about what it will bill the family if the application is denied.

Expect 45 to 90 days. If the state asks for more documents, answer inside the deadline on the request, because a missed request is a denial. If the application is denied, the notice carries a fair hearing right with its own deadline, and the state guide says how to use it. The Medicare and nursing home costs guide covers the 100-day Medicare period that usually comes first.

Mistakes That Waste Nursing Home Medicaid Limits

The first mistake is spending down to the federal $2,000 in a state that allows more. The second is applying in an income-cap state without the trust. The third is treating the spouse’s separate accounts as protected; they are counted, then the allowance is carved out. The fourth is giving the house to a child inside the look-back and discovering the penalty at the worst possible moment.

The fifth is paying the facility privately during a penalty period without checking whether the transfer that caused it was exempt — the caregiver-child transfer often is, and families pay six figures they did not owe. The sixth is confusing the nursing home medicaid limits with the Medicare Savings Program limits, which are far higher and have no look-back; the Medicare Savings Programs directory covers those.

The last mistake is waiting until the money is gone to apply. The smarter sequence is to apply while the parent is still paying privately, so the approval lands the month the private funds end and the facility never has a gap. The state guide gives the timing for each state’s office.

Medicare First: The 100 Days Before Medicaid

Most nursing home stays begin with Medicare, not Medicaid, and the nursing home medicaid limits only matter once Medicare stops; and the handoff is where families lose money. After a qualifying three-day inpatient hospital stay, Part A covers up to 100 days of skilled care in a facility — fully for the first 20 days, then with a daily coinsurance — and only while the resident needs skilled services. The Medicare and nursing home costs guide walks the count, and the Part A deductible guide gives the 2026 figures.

Two traps sit inside those 100 days. The first is observation status: a hospital stay logged as observation rather than inpatient does not count toward the three days, and the rehab bill lands on the family. The second is the improvement standard myth: a facility that says Medicare stopped paying because the resident is not getting better is wrong, and the skilled nursing denial guide explains the fast appeal.

When Medicare ends, the resident pays privately or Medicaid pays, and the application should already be in. A family that starts the Medicaid application on the day Medicare stops has a gap of two to three months at the private rate. The 100-day cutoff guide covers the notice that arrives at the end and what to do with it, and the discharge appeal guide covers the fast appeal when the hospital pushes a parent out before the facility bed is ready.

Home Care, Assisted Living and Hospice: The Alternatives Medicaid and Medicare Pay For

Not every parent who meets the level-of-care test and the nursing home medicaid limits has to enter a facility. The same Medicaid eligibility, in most states, unlocks home and community-based care under a waiver, and the state can pay a relative to provide it — the Family Caregiver Pay by State directory covers each state’s program. Medicare pays for a different, shorter benefit: the Medicare home health guide explains the skilled-need rule that limits it, and the durable medical equipment guide covers the hospital bed and the walker.

Assisted living is the gap the nursing home medicaid limits do not touch. Medicare does not pay for it at all, and Medicaid pays for the care component in some states through a waiver but never for room and board; the Medicare and assisted living guide draws the line. Hospice, by contrast, is a Medicare benefit that continues in a nursing home, and the hospice and Medicare guide explains how the two coordinate when a Medicaid resident enters hospice.

A parent who qualifies for nursing home Medicaid is also dual eligible — Medicare and Medicaid together — which changes the Medicare Advantage picture. The dual eligible guide explains what Medicaid picks up, the D-SNP guide covers the plans built for that combination, and the Medicaid and Advantage choices guide explains when it is worth switching. The QMB guide covers the program that pays the Part B premium for the resident.

The Paperwork Nobody Has: Authority, Records and the Move

The application against the nursing home medicaid limits asks for five years of statements, and the person applying is rarely the parent. An adult child needs authority to get the records and sign the form: a financial power of attorney, or a bank’s own form where the institution insists. The Medicare power of attorney guide covers the documents that let a child act, and the dementia guide covers what to do when the parent can no longer sign. The estate planning and Medicare guide lists what to have in place before any of this starts.

Records are the second gap in most nursing home medicaid limits applications. The Medicare Summary Notice guide explains the statements the family will be asked to reconcile against the facility’s bills, and the premium deduction guide explains why the Social Security deposit is smaller than the gross figure Medicaid counts. A family managing from a distance will find the long-distance management guide and the remote tools guide cover the logistics.

Moving a parent across a state line resets everything. The nursing home medicaid limits change, the application starts over in the new state, and Medicare Advantage plans do not follow. The parent moves states guide covers the sequence, and the Medicare fraud guide is worth a read before any facility or planner asks for money up front. For a veteran, Aid and Attendance is a separate monthly benefit that can be held alongside Medicaid in most states, subject to the income rules.

When to Get Help

A single applicant with a house, a few accounts and no gifts in five years can usually apply with the state guide and the agency’s checklist. Three situations change that. A married couple with assets near or above the resource allowance, where the state’s formula decides tens of thousands of dollars. Gifts or transfers inside the look-back, where an attorney can often reclassify or cure them. And an income-cap state, where the trust has to be drafted.

Legal aid offices, the state long-term care ombudsman and the Area Agency on Aging handle Medicaid questions daily at no cost. Elder law attorneys handle the contested and the complex ones, and the Filial Responsibility by State directory covers what happens when a facility turns to the adult children instead. The Medicare vs Medicaid guide is the place to start for anyone still unsure which program pays for what.

Nursing Home Medicaid Limits: Frequently Asked Questions

What are the 2026 income and asset limits for a single person?

Income: $2,982 a month in the 25 income-cap states, or the state’s medically needy line elsewhere. Assets: $2,000 in 35 states and a state-specific figure in 15 others; the table above gives each state’s asset figure and the state guide gives the income figure.

Does my mother lose the house?

Not to qualify. The home is exempt while she intends to return or a spouse or dependent lives there, up to the state’s equity cap. Whether the state can claim it after her death is estate recovery, a separate question with its own exemptions, covered in the state guide.

My father’s income is $3,100. Is he over?

In an income-cap state, yes, by $118 — and a qualified income trust for that excess makes him eligible. In a medically needy state he qualifies by paying the excess toward care. The table says which system his state uses.

What does the spouse at home keep?

Between $32,532 and $162,660 of countable assets in 2026, by the state’s formula, plus the home and car, plus enough of the applicant’s income to reach the monthly maintenance allowance. The state guide gives the formula.

Can we give the house to my sister?

Inside the look-back it is a penalized transfer — unless she lived there for two years and provided care that kept the parent out of a facility, in which case it is exempt in every state. Document the residence and the care before the application.

How are the nursing home medicaid limits different from Medicare?

Medicare pays for up to 100 days of skilled rehab after a hospital stay and has no income or asset test. Medicaid pays for long-term custodial care and tests both. Most residents use Medicare first and Medicaid after, and the applications do not conflict.

Is the personal needs allowance the same everywhere?

No. Each state sets it, and the range is wide. The state guide gives the figure, because it is the amount the resident actually keeps each month after the patient liability is paid to the facility.

Find Your State’s Exact Limits

The table above is the short version. Every state has a full guide with the income figure, the spouse formula, the penalty divisor, the personal needs allowance, the office, and the application steps — and the nursing home medicaid limits picture changes once you read your own state’s page.

See Every State’s Guide →

Sources & How to Verify

The figures on this page are drawn from the 2026 federal SSI and spousal impoverishment standards published by CMS, each state’s own Medicaid eligibility pages, and the verified state guides on this site. Every figure resets on a schedule, so always confirm the current one with your state guide or the office named there.

• Centers for Medicare & Medicaid Services: www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf – the December 2025 informational bulletin setting the 2026 SSI and spousal impoverishment figures
• Medicaid.gov: www.medicaid.gov/medicaid/eligibility/index.html – federal eligibility rules and the transfer-of-assets look-back
• Administration for Community Living: acl.gov – the state long-term care ombudsman programs
• Table rows: medicarecoverguide.com/nursing-home-medicaid-by-state – each state’s asset figure and cap status was read from the state’s own Medicaid page or the agency rule it cites; open the state guide for the direct citation

Content last reviewed September 2026. If you notice outdated information, please contact us.

Related Guides

In depth on this topic:

• Nursing Home Medicaid by State — every state’s guide in one directory
• Medicare and Nursing Home Costs — What’s Covered and For How Long
• Medicare vs Medicaid — Differences, Dual Eligibility, and Costs
• Dual Eligible — Having Both Medicare and Medicaid Explained

The steps that come next:

• Filial Responsibility by State — when the facility bills the children
• Medicaid Home Care by State — the waiver that keeps a parent home
• Family Caregiver Pay by State
• The 100-Day Rehab Cutoff — When Medicare Stops Paying
• Observation Status and the 3-Day Rule

Premium help without a nursing home:

• Medicare Savings Programs by State
• QMB, SLMB, QI and QDWI Eligibility Guide

Medicare’s part, before Medicaid:

• What Medicare Part A Covers
• Medicare Part A Deductibles and Coinsurance
• Skilled Nursing Facility Denial
• The Improvement Standard Myth
• Appealing a Hospital Discharge
• Medicare and Home Health Care
• Medicare and Assisted Living
• Hospice and Medicare

For the adult child running it:

• Helping Your Parent Navigate Medicare — The Complete Guide
• Medicare Power of Attorney
• Managing Medicare for a Parent with Dementia
• Estate Planning and Medicare
• Managing a Parent’s Medicare from Far Away
• When Your Parent Moves to a Different State
• How to Find a Free SHIP Counselor
• Warning Signs of Medicare Fraud Targeting Your Parent

Dual eligibility and the plan question:

• D-SNP Plans — Pros and Cons
• How Medicaid Changes Your Medicare Advantage Choices
• VA Aid and Attendance

• All State Guides in This Cluster
• Helping Parents With Medicare

Informational only — not legal, tax or financial advice. Medicare Cover Guide is an independent educational resource, not a government agency, an insurer, or a law firm. Rules, deadlines and figures change by legislation and vary by state. For your specific situation, contact your state SHIP counselor, the office named in your state guide, or a licensed attorney in your state.