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A Guide to Nursing Home Requirements for Seniors
Date Updated: July 26, 2024
Written by:
Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.
Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers
It’s natural for your health care needs to increase with advancing age, and eventually, you might need to find a nursing home that can deliver the care you need. Unfortunately, it can be confusing and difficult to research nursing home care on your own and to find a place that’s right for you. This guide is meant to help with your search.
If you’re one of the 1.3 million seniors who need the care that 24-hour nursing provides, or if you’re the family member of an older adult who needs help finding good nursing home care, this article can help you know what to look for, assess costs and pick a facility that’s a good fit for your situation.
What Qualifies a Person for a Nursing Home?
There is no universally agreed-upon set of criteria for who should be admitted to a nursing home and who should not be, but a standard of sorts has developed around the Medicaid standard for when nursing home services will be covered for beneficiaries. Each state sets its own standards and details vary, but in general, a person may be admitted to a nursing home if they have:
- Limited physical ability: People with disabilities are potentially eligible for admission to a nursing home. The disabilities may be a serious impairment, or they may be instrumental. A person whose disabilities interfere with activities of daily living, such as bathing, dressing or meal preparation, may require admission for basic safety and health reasons.
- Health or medical needs: People with special medical needs or chronic health conditions may need skilled nursing care from the inpatient environment of a nursing home. The health issue can be almost anything that your doctor and your state consider disabling or potentially hazardous without skilled nursing care.
- Cognitive impairment: Seniors with cognitive impairments sometimes need the 24-hour supervision and mental health therapy available in a nursing home. This may be due to Alzheimer’s disease, Huntington’s chorea or advanced Parkinson’s disease dementia.
- Behavioral issues: Disturbed or irregular behavior can drive the decision to seek nursing home placement. A senior who gets confused and wanders, seeks escape from indoor environments or gets violent without an obvious cause might only have their needs met with the personal care and expertise a nursing home offers.
What Documents Are Needed for Nursing Home Admissions?
When you’re admitted to a nursing home, the facility needs to see certain documents. Some of these are needed in every state, some relate to payment authorization or medical decision-making and others are optional or may be produced after you’ve been admitted. To make the process go smoothly, it helps to have these documents in hand before admission:
- Doctor’s orders for admission: A nursing home requires a doctor’s recommendation. This can be as simple as a one-page form, or might even be done electronically or over the phone. The documentation is similar to a doctor’s order to admit you to the hospital.
- Doctor’s prescriptions: Your prescriptions travel with you wherever you’re being treated. Your doctor has to make sure that the medications you need are authorized for disbursal by the nursing home staff. This can also usually be done electronically.
- Detailed medical history: Your medical history is a private set of documents that describes the medical conditions you have, the treatments you’ve received, physician’s notes and several other sensitive bits of information. It almost always travels with you from one facility to another in a special envelope that has to be handed over to your caregiver upon transfer.
- Test results: The nursing staff needs to have a copy of any of your recent test results. These are likely to be in your medical history packet, but it’s good to make sure they’ve been properly transferred.
- A state-approved admission form: Every state requires a nursing home admission form to be filled out at the time of your admission. This form differs in detail from one state to another, but just about every admission includes a completed form that gets filed with the state.
- Facility admission paperwork: Just as the state tracks nursing home admissions, the facilities themselves have various forms to fill out. In many cases, you can fill these out before you arrive at the facility. You could also have a caregiver, loved one or nursing home staff member do it for you.
In addition to these required forms, you might also be asked for a few supplemental documents. These don’t usually have to be presented prior to admission, but the sooner they are on file, the better:
- Durable power of attorney: As a rule, it’s a good idea to designate a third party as your medical decision-maker. It may happen that you need treatment or transfer to another facility and are unable to give your consent. You can name somebody on a legal document to make those decisions for you if needed, and their consent will be as legally binding as yours would have been.
- Do-not-resuscitate (DNR) orders: Many people, especially those with end-stage conditions, decide to “let nature take its course” with their health and accept a natural death. A properly filed DNR is a record of your wishes not to be resuscitated if your heart stops, and against heroic measures being taken to keep you alive if you are passing away.
- End-of-life wishes: End-of-life care wishes are your advance statements about how you want to be treated near the end of your life and immediately after in case you’re unable to make decisions at the time. Typical wishes might be that you want hospice care at home, you want continuous, deep sedation, you wish to be cremated and so on.
- Dietary needs: You’ll be eating meals at the nursing home, and it’s a good idea to let the staff know in advance whether you have any food allergies, sensitivities (medical or cultural) or special dietary needs. For ordinary requests, such as kosher meals, vegetarian menus only or a low-salt diet, it’s usually enough to jot your requests down and submit them, but some people prefer a more formal document.
Nursing Home Financial Assessment
As a normal part of the admission process, the care facility is likely to conduct a financial assessment. This is generally done to determine whether you’re eligible for any state or federal support while you’re in residence. This can be important since nursing homes are not allowed to ask for deposits or other out-of-pocket payments from Medicaid or Medicare beneficiaries.
The financial assessment is in many ways similar to the application process for a mortgage. Many of the same documents and life circumstances are looked at to determine whether you need help paying for your stay. Commonly asked questions during this assessment include:
- Are you currently enrolled in Medicare Parts A, B or C? Do you plan to apply?
- Do you have supplemental insurance to cover non-Medicare costs? Are you dual-eligible for both Medicare and Medicaid?
- Do you get VA benefits, Social Security, SSI/SSDI, railroad pension benefits or other income?
- What assets do you have, such as CDs or a 401(k)?
- Have you transferred significant assets to anyone else in the last 3-5 years?
- What is your current living situation (i.e. do you own a house, rent, live with somebody, etc.)?
- How much are you paying for your mortgage or monthly rent?
How to Choose a Nursing Home
Whatever the reason you’re going into a nursing home, and regardless of how long you plan to stay, there are some things you or your loved ones should look for in any place you’re seriously considering admission to.
Nursing Home Laws By State
Click on your state on the map below to learn about nursing home laws in your state.
The Cost of Nursing Homes
Nursing home care in the United States costs an average of $7,908 a month for a semiprivate room, according to Genworth’s 2021 Cost of Care Survey. This rises to $9,034 for private rooms. This is a national figure, and the true cost of a room varies widely between states, as well as between urban areas within states. Care costs in the District of Columbia, for example, average $10,494 a month for both private and semiprivate rooms, while nursing home care in Louisiana can be as low as $5,759 for semiprivate rooms and $6,060 for private ones.
There’s even more cost variation between types of senior care. For some people, especially seniors who don’t quite need the full spectrum of care a nursing home provides, other types of living arrangements might be more affordable and more appropriate. This table lists common costs for different care levels:
|
Level of Care |
National Median Cost (Monthly) |
|---|---|
|
Nursing Home (semiprivate room) |
$7,908 |
|
Nursing Home (private room) |
$9,034 |
|
Assisted Living |
$4,500 |
|
Home Health Care |
$5,148 |
How to Pay For Nursing Home Care
Medicare
Medicare commonly pays for nursing home care, both for established beneficiaries and for adults who have certain chronic conditions, such as end-stage renal disease. Under Original Medicare Part A, the inpatient benefit, the program pays for medically necessary services for a limited time. Medicare-covered services include:
- Lodging in a semiprivate room
- Meals, including special menu requirements
- Nursing care
- Physical, occupational and speech therapy
- Medically necessary social services
- Prescription medication
- Durable and disposable medical supplies
- Medically necessary transportation by ambulance
- Nutritional counseling and diabetes education
These benefits are available for a maximum of 100 days per benefit period, with a sliding scale of cost sharing. Your stay’s share of cost falls into three categories:
|
Duration |
Share of Cost |
|---|---|
|
Days 1 - 20 |
$0 coinsurance |
|
Days 21 - 100 |
Up to $200 coinsurance per day |
|
Days 101+ |
No coverage |
Seniors who have the minimum necessary work credits are generally eligible for Medicare Part A at no cost. Other parts of Medicare have a monthly premium and may be opted out of for other coverage.
You can learn more about Medicare coverage limits at Medicare.gov.
Medicaid
Medicaid is a low-income health insurance program that helps provide medically necessary services for millions of seniors nationwide. All medically necessary services are included under your Medicaid benefit, with some variation in copayment amounts based on your ability to pay. This includes all doctor-authorized services provided while you’re staying at a nursing home.
Every state sets its own eligibility requirements for who can sign up for Medicaid. You generally need to have a qualifying low income and limited personal assets with some kind of medical need, such as being over age 65.
Click on your state on the map below to learn about your Medicaid eligibility requirements.
California
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | No Limit | $130,000 | |
| Two Person | 1 | No Limit** | $130,000 | $148,620 |
| Two Person | 2 | No Limit | $195,000 |
*All monthly income except for a $35/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spous.
**Income limit is for applicant only.
Texas
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,680 |
| Two Person | 2 | $65,808 | $2,000 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Florida
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808*** | $3,000 |
*All monthly income except for a $130 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
New York
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $20,124 | $30,182 | |
| Two Person | 1 | $20,124** | $30,182 | $148,620 |
| Two Person | 2 | $27,216 | $40,821 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Pennsylvania
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S)**** | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,680 |
| Two Person | 2 | $65,808*** | $4,000***** |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****In addition to the asset limits listed, Pennsylvania allows an extra $6,000 exemption. However, if an applicant has income more than $2,523/mo., the asset limit is $2,400 rather than the total asset limit of $8,000 ($2,000 plus $6,000 disregard).
*****Assets are limited to $2,000 per spouse
Illinois
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $14,580 | $17,500 | |
| Two Person | 1 | $14,580** | $17,500 | $148,680 |
| Two Person | 2 | $19,716 | $17,500 |
*All monthly income except for a $30/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
Ohio
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,680 |
| Two Person | 2 | $65,808 | $3,000 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Georgia
Medicaid Eligibility
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,680 |
| Two Person | 2 | $65,808 | $2,000 | |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
North Carolina
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | Must be less than the amount Medicaid pays for nursing home care (est. $6,381 to $9,087/mo) | $2,000 | |
| Two Person | 1 | Less than the amount Medicaid pays toward the facility. | $2,000 | $148,620 |
| Two Person | 2 | Must be less than the amount Medicaid pays for nursing home care (est. $6,381 to $9,087/mo) | $3,000 |
*Income must be less than the amount Medicaid pays for nursing home care. Estimated cost is $6,381 – $9,087/mo. Except for a $30/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
Michigan
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,680 |
| Two Person | 2 | $65,808*** | $3,000 |
*Except for a $60/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
New Jersey
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808 | $3,000 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Virginia
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808 | $3,000 |
*Except for a $40/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Washington
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808*** | $3,000 |
*Except for a $100/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
Arizona
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808*** | $4,000**** |
*All monthly income except for a $137.10/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****$2,000 per spouse
Massachusetts
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $14,580 | $2,000 | |
| Two People | 1 | $14,580** | $2,000 | 148,620 |
| Two People | 2 | $19,716 | $4,000*** |
*Except for a $72.80/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***$2,000 per spouse
Tennesee
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | 148,620 |
| Two People | 2 | $65,808*** | $4,000**** |
* Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,000 per spouse
Indiana
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
*All monthly income except for a $52 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
Missouri
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | No set limit | $5,726 | |
| Two People | 1 | No set limit | $5,726 | 148,620 |
| Two People | 2 | No set limit |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
Maryland
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | Cannot exceed the cost of nursing home care | $2,500 | |
| Two People | 1 | Cannot exceed the cost of nursing home care | $2,500 | 148,620 |
| Two People | 2 | Cannot exceed the cost of nursing home care | $6,000** |
*Except for a $93/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**The initial asset limit is $3,000 per spouse. After six months, this limit goes to $2,500 per spouse.
Wisconsin
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808 | $4,000 |
*Except for a $45/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Colorado
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808*** | $4,000 |
*All monthly income except for a $95.97/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
***Asset limit is $4,000 per couple if sharing a room and $3,000 if in separate rooms.
Minnesota
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $14,580 | $3,000 | |
| Two Person | 1 | $14,580** | $3,000 | $148,620 |
| Two Person | 2 | $19,728 | $6,000 |
*Except for a $121/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
South Carolina
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $4,000 | |
| Two Person | 1 | $32,904** | $4,000 | $66,480 |
| Two Person | 2 | $65,808 | $8,000 |
*Except for a $30/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Alabama
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | 148,620 |
| Two People | 2 | $65,808*** | $4,000**** |
*All monthly income except for a $30/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****$2,000 per spouse
Louisiana
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808 | $3,000 |
*All monthly income except for a $38 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse,
**Income limit is for applicant only.
Kentucky
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $4,000 |
*All monthly income except for a $40 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
Oregon
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808 | $4,000 |
*Except for a $74,75/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Oklahoma
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808 | $4,000*** |
*Except for a $75/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Assets are limited to $2,000 per spouse
Connecticut
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | Must be less than the cost of the nursing home | $1,600 | |
| Two People | 1 | Must be less than the cost of the nursing home | $1,600** | $148,620 |
| Two People | 2 | Must be less than the cost of the nursing home | $3,200*** |
*All monthly income except for a $60/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.
**Income limit is for applicant only.
***Limit is $1,600 per spouse
Utah
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | No set income limit | $2,000 | |
| Two People | 1 | No set income limit | $2,000 | $148,620 |
| Two People | 2 | No set income limit | $4,000** |
*Except for a $45/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Assets are limited to $2,000 per spouse
Iowa
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808 | $3,000**** |
*All monthly income except for a $50 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****After six months of Medicaid eligibility, the rules for married couples change. They can then can choose to be considered as single applicants, which would change the asset limit to $2,000 each spouse.
Nevada
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
*Except for a $35/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
Arkansas
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $4,000 |
*All monthly income except for a $137.10/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse.
** Income limit is for applicant only.
*** Income is limited to $2,742 per month per spouse.
Mississippi
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $4,000 | |
| Two People | 1 | $32,904** | $4,000 | $148,620 |
| Two People | 2 | $65,808*** | $6,000 |
* Except for a $44/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
** Income limit is for applicant only.
*** Income is limited to $2,742 per month per spouse.
Kansas
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | No Income Limit | $2,000 | |
| Two People | 1 | No Income Limit | $2,000 | $148,620 |
| Two People | 2 | No Income Limit | $3,000 |
* Income in excess of $62/mo. must go toward nursing home costs. There are exceptions for private health insurance and potentially a spousal income allowance for a non-applicant spouse.
New Mexico
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $66,808*** | $4,000*** |
* Except for a $83/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
** Income limit is for applicant only.
*** Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,000 per spouse
Nebraska
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $14,580 | $4,000 | |
| Two People | 1 | $14,580** | $4,000 | $148,620 |
| Two People | 2 | $19,716 | $6,000*** |
*Except for a $60/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Assets are limited to $4,000 per spouse
West Virginia
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
Idaho
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $33,144 | $2,000 | |
| Two People | 1 | $33,144** | $2,000 | $148,620 |
| Two People | 2 | $66,048 | $4,000*** |
*All monthly income except for a $40/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.
**Income limit is for applicant only.
***The limit is $2,000 each but may vary on a case-by-case basis.
Hawaii
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | No hard limit | $2,000 | |
| Two People | 1 | No hard limit | $2,000 | $148,620 |
| Two People | 2 | No hard limit | $3,000 |
*All monthly income except for a $50/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .
New Hampshire
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,500 | |
| Two People | 1 | $32,904** | $2,500 | $148,620 |
| Two People | 2 | $65,808*** | $5,000**** |
*Except for a $74/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,500 per spouse
Maine
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S)**** | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $10,000 | |
| Two People | 1 | $32,904** | $10,000 | $148,620 |
| Two People | 2 | $65,808*** | $15,000***** |
*All monthly income except for a $40 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse,
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****The asset limit is technically $2,000 for an individual and $3,000 for a couple. However, Maine allows an extra exemption of $8,000 in savings for an individual and $12,000 for a couple.
*****The $15,000 asset limit is for couples sharing a room in the same facility. For those in separate rooms or different facilities, the asset limit is $10,000 each, for a total of $20,000.
Montana
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | Income must be less than nursing home costs | $2,000 | |
| Two People | 1 | Income must be less than nursing home costs** | $2,000 | $148,620 |
| Two People | 2 | Income must be less than nursing home costs | $4,000** |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Assets are limited to $2,000 per spouse
Rhode Island
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $4,000 | |
| Two People | 1 | $32,904** | $4,000 | $148,620 |
| Two People | 2 | $65,808*** | $8,000**** |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $4,000 per spouse.
Delaware
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $27,420 | $2,000 | |
| Two People | 1 | $27,420 | $2,000 | $148,620 |
| Two People | 2 | $54,840** | $3,000 |
*All monthly income except for a $50/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
South Dakota
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
* Except for a $60/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
** Income limit is for applicant only.
*** Income is limited to $2,742 per month per spouse.
North Dakota
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | No set limit | $3,000 | |
| Two People | 1 | No set limit | $3,000 | $148,620 |
| Two People | 2 | No set limit | $6,000 |
*Except for a personal needs allowance of $65/mo. for single and $130/mo. for couples who are both recipients, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
Vermont
Medicaid Eligibility
| ANNUAL INCOME LIMITS | ASSET LIMITS | |
|---|---|---|
| Single Applicant | $32,904 | $2,000 |
| Two-Person Household (Only One Person Applying) | $32,904* ** | $2,000 for applicant, $148,620 for non-applicant |
| Two-Person Household (Both People Applying) | $65,808* | $3,000 |
*;Except for a $72.66/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Wyoming
Medicaid Eligibility
| HOUSEHOLD SIZE | NUMBER OF APPLICANTS | INCOME LIMITS PER YEAR* | ASSET LIMITS: APPLICANT(S) | ASSET LIMITS: NON-APPLICANTS |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
Veterans Benefits
The VA pays some or all of the cost for many medically necessary nursing home services. Benefits cover some of the most common costs, such as nursing care and therapeutic services. Partial coverage may be provided for some services, though this varies with your service status, disability status and ability to pay. VA benefits may be combined with Medicare and Medicaid for better coverage.
You may be able to access VA inpatient benefits if you are otherwise eligible for VA care at a hospital. If you are a qualifying veteran, your case manager can tell you more about your specific benefits.
Learn more about the VA’s nursing home benefits at VA.gov.
Private Insurance
Many private health insurance plans have some nursing home benefits. These vary widely by company, plan and even by location. Be sure to ask your plan representative for definitive information about your benefits.