Medicaid Planning
Medically Needy Medicaid Pathway (2026)
Share-of-cost and medically needy programs for seniors who exceed income limits but have high care costs.
6 min readUpdated 2026-06-20
Medically needy (or share-of-cost) pathways allow eligibility when medical expenses reduce income below state thresholds. Not all states offer this pathway for long-term care.
States with medically needy programs
Coverage and income thresholds differ. Use our state pages to screen preliminary eligibility and contact your ADRC for official determination.
State Medicaid screeners
- Texas
- Florida
- California
- New York
- Pennsylvania
- Ohio
- Illinois
- Georgia
- Arizona
- North Carolina
- Michigan
- New Jersey
- Washington
- Massachusetts
- Virginia
- Colorado
- Minnesota
- Wisconsin
- Missouri
- Tennessee
- South Carolina
- Indiana
- Maryland
- Alabama
- Alaska
- Arkansas
- Connecticut
- Delaware
- Hawaii
- Idaho
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Mississippi
- Montana
- Nebraska
- New Hampshire
- North Dakota
- New Mexico
- Nevada
- Oklahoma
- Oregon
- Rhode Island
- South Dakota
- Utah
- Vermont
- West Virginia
- Wyoming
- District of Columbia
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