Medicaid for Assisted Living Facilities & Nursing Homes

Yes. In all 50 states, Medicaid covers skilled nursing facility care for eligible residents — including room, board, and medical services — when income, asset, and level-of-care requirements are met. Assisted living coverage is more limited and varies by state waiver.

You generally need to pass a financial test (income and countable assets within state limits), survive the 60-month asset look-back review, and receive a clinical determination that nursing-facility-level care is medically necessary. Each state administers its own Medicaid program with slightly different rules.

The federal look-back period is 60 months (5 years) before your Medicaid application date. States review asset transfers during this period; gifts or below-market sales can trigger a penalty period during which Medicaid will not pay for nursing home care.

Income limits for many states align near $2,829/month for individuals in 2026 (SSI-related standards). Asset limits are commonly $2,000 for an individual and $3,000 for a couple, with important exclusions for a primary home and one vehicle. New York and Minnesota have higher limits — use our state pages for exact figures.

In most states, Medicaid does not pay for room and board in assisted living. HCBS waivers may cover care services for eligible residents.

No. This is an educational screening tool. Only your state Medicaid office can make an official eligibility determination.

The federal income screening threshold for nursing home Medicaid is $2,901/month in 2025 (300% of the SSI Federal Benefit Rate). In 'income cap' states like Texas, Florida, and Georgia, applicants above this limit must use a Miller Trust to qualify. In 'medically needy' states like California and New York, excess income is applied monthly toward care costs as an income spend-down.

Income cap states (e.g., Texas, Florida, Arizona, Georgia) set a hard income ceiling — if monthly income exceeds $2,901 in 2025, the applicant cannot qualify without establishing a Miller Trust (Qualified Income Trust). Medically needy states (e.g., California, New York, Illinois, Pennsylvania) allow applicants to 'spend down' excess income each month by contributing it toward nursing home costs, then Medicaid covers the remainder.

Under federal spousal impoverishment protections (MCCA 1988), the community spouse (who remains at home) may keep between $30,828 and $154,140 in countable assets (2025 federal limits), plus the primary home, one vehicle, and personal property. The institutionalized spouse must reduce their share to the state's individual limit — typically $2,000. Some states set the community spouse minimum higher than the federal floor.

If you transferred assets for less than fair market value within the 60-month look-back period, Medicaid imposes a penalty — months during which Medicaid will not pay for nursing home care. The penalty equals the amount transferred divided by your state's average private-pay nursing home cost (the 'penalty divisor'). For example, a $70,000 gift in a state with a $7,000/month divisor creates a 10-month penalty. There is no cap on how long a penalty can last.