How the Medicaid eligibility check works
Medicaid is the largest single payer of long-term care in the United States — covering nursing home care, in-home care, assisted living services (through HCBS waivers in most states), and adult day programs. Eligibility depends on three things: your income, your countable assets, and whether you have a medical need for the level of care you're requesting.
Our checker uses 2026 federal limits and the most common state rules to give you a quick estimate. Final eligibility is determined by your state Medicaid agency.
Key 2026 numbers
- Long-term care income limit (most states): $2,901 per month for a single applicant — 300% of the SSI federal benefit rate.
- Countable asset limit: $2,000 individual / $3,000 couple (when both apply).
- Community spouse asset allowance: $30,828 minimum, $157,920 maximum.
- Community spouse income allowance: $3,853 maximum monthly.
- Home equity limit: $730,000 standard, up to $1,097,000 in higher-cost states.
- Look-back period for asset transfers: 60 months in 49 states; 30 months in California (transitioning to 60).
What's exempt from the asset limit
- Your primary residence, if you or your spouse, minor child, or disabled child lives there or intends to return.
- One vehicle, regardless of value.
- Personal belongings, household goods, and furniture.
- One pre-paid funeral or burial contract per person.
- A small life insurance policy with face value under $1,500.
- IRAs in some states (notably California) if in payout status; counted in others.
What happens if you're over the income limit
Most "income cap" states allow you to qualify by setting up a Qualified Income Trust (Miller Trust) that holds the excess income each month and pays it toward your care. Other states use a Medically Needy "spend-down" approach where you pay down income on medical bills until you fall under the limit. A few states have neither — those are the hardest to qualify in.
What happens if you're over the asset limit
You generally cannot just give assets away — Medicaid's 5-year look-back will penalize transfers and delay your coverage. Legitimate strategies include: spending down on medical care, repairs to your home, paying off debt, prepaying funeral costs, buying an annuity that meets state rules, or in some cases moving assets into a properly structured irrevocable trust well before applying. This is where an elder-law attorney is genuinely worth the consult fee.
Frequently Asked Questions
What income disqualifies you from Medicaid in 2026?
For Medicaid long-term care in most states in 2026, individual monthly income above $2,901 (300% of the SSI federal benefit rate) generally disqualifies you for the standard pathway. Some states use Medically Needy programs or Qualified Income Trusts (Miller Trusts) to let people with higher incomes still qualify. For MAGI Medicaid (general health coverage) for adults under 65, the limit is roughly 138% of the federal poverty level in expansion states — about $1,732 per month for an individual.
What is the asset limit for Medicaid long-term care in 2026?
Most states limit countable assets to $2,000 for an individual applicant and $3,000 for a couple where both apply. A primary residence (up to $730,000–$1,097,000 of equity, state-dependent), one vehicle, and personal belongings are exempt. The spouse who stays in the community can keep up to $157,920 in assets in 2026.
Does Medicaid pay for assisted living?
Medicaid generally does not pay for room and board at assisted living, but most states have an HCBS waiver that covers the care services delivered inside assisted living. Coverage rules vary widely — Texas STAR+PLUS, New York ALP, California ALW, and Florida SMMC LTC each work differently. Always check the specific waiver in your state.
What is the Medicaid 5-year look-back?
When you apply for Medicaid long-term care, the state reviews the 60 months prior to your application for asset transfers below fair market value. Such transfers can trigger a penalty period during which Medicaid will not pay for care. The penalty length depends on the amount transferred and the state's average monthly cost of care. California uses 30 months and is in the process of extending to 60 months.
Can I keep my house and still qualify for Medicaid?
Yes, in most cases. A primary residence is exempt as long as you (or your spouse, minor child, or disabled child) live there or intend to return. However, after death the state may try to recover Medicaid expenses from the estate, including the home, through Medicaid Estate Recovery. Several legal strategies exist to protect the home for heirs; an elder-law attorney can advise.
How long does Medicaid take to approve?
Federal law requires a decision within 45 days for most applications and 90 days for disability-based applications. In practice, many states miss these deadlines. If your application is pending and care is needed urgently, ask about presumptive eligibility or retroactive Medicaid (covering up to 3 months of care before application date).
Will my children's income or assets affect my eligibility?
No. Adult children's income and assets are not counted toward a parent's Medicaid eligibility. Only the applicant's and the applicant's spouse's resources are considered. However, money you receive from family members may count as income in the month received.
What if I have Medicare? Can I still get Medicaid?
Yes. Millions of Americans are "dual-eligible" — they have both Medicare and Medicaid. Medicare covers most medical and hospital costs; Medicaid fills the gaps including long-term care, copays, and dental in many states. The two programs are designed to work together.