Paying for care

Medicaid Income Limit for Nursing Home Care in 2026

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By Nursing Home Checker · Updated Oct 24, 2026 · How guides are checked · Share

What is the income limit for nursing home Medicaid in 2026?

The federal maximum for the nursing home "income cap" group is $2,982 a month for one person in 2026. Federal law lets states cover people who are in a medical institution, such as a nursing home, for at least 30 days in a row and whose income does not exceed "a separate income standard established by the State." That standard must stay within the federal limit of 300% of the SSI benefit rate. CMS calls this the "special income level" group.

CMS publishes these figures in its 2026 SSI and Spousal Impoverishment Standards chart, updated April 27, 2026. Medicaid is run by each state inside these federal rules, so there is no single income limit across the country.

Who is eligible for nursing home Medicaid?

Nursing home Medicaid has both a medical test and a financial test. Medicaid.gov says states must provide nursing facility services to people age 21 or older "who need them." Each state defines that need through its own nursing facility level-of-care criteria. People with serious mental illness or intellectual disability must also be evaluated by the state's Preadmission Screening and Resident Review (PASRR) program.

For the financial test, the federal regulation for the income cap group lets a state cover "aged, blind, and disabled individuals in institutions" whose income is below the level set in the state plan. The person must also meet the asset limit, explained below. For the full set of rules, including what happens to the home, see how Medicaid pays for a nursing home and the documents needed to apply.

Income-cap states vs. medically needy states: what is the difference?

The difference is what happens when income is over the state's level. Covering the special income level group is a state choice: the federal regulation says a state "may" cover it, and CMS says each state sets its own standard. A state may use the full 300% of the SSI rate or a lower percentage or fixed dollar amount.

CMS does not publish a list on its eligibility page of which states use each route. The state Medicaid agency is the place to confirm your state's rule and figure. On this site, state pages such as nursing homes that accept Medicaid in Texas show what has been checked for that state.

What income counts toward the nursing home income limit?

All of the person's income counts. CMS describes the special income level as a gross income standard: "all of the individual's income is counted, with no deductions." Federal law counts income under SSI rules but without the usual SSI income exclusions. Under those SSI rules, amounts withheld from a benefit, such as Medicare premiums, still count as income.

CMS calls the 300% limit a "hard cap." A state that uses 300% of the SSI rate cannot apply looser income-counting methods to get around it. Income above 300% of the SSI rate cannot qualify under this group in any state.

Assets are tested too. CMS says the resource (asset) standard for this group is the one used by the most closely related cash program. For someone 65 or older, that is the SSI standard, which is $2,000 for one person in the CMS 2026 chart. A state may use less restrictive rules for counting resources.

Does the person have to be in the nursing home for 30 days?

Yes, for the income cap group. Federal law requires the person to be in a medical institution for at least 30 days in a row, with eligibility "beginning on the first day of such period." CMS says the 30 days must be continuous but do not have to be in the same institution, so a hospital stay followed directly by a nursing home stay can count. In CMS's example, a return home in between restarts the count.

What happens if income is over the Medicaid limit for a nursing home?

What happens depends on the state's route. In an income-cap state that does not cover nursing home care for the medically needy, federal law allows a qualified income trust. In a state with a medically needy program, medical expenses that no third party will pay, including nursing home costs, are counted against income.

Medically needy programs (spend-down)

Medicaid.gov says states have the option of a "medically needy program" for people with significant health needs whose income is too high for other groups. Under federal rules, if countable income is above the state's standard, the agency must deduct medical expenses the person has incurred that no third party will pay, including Medicare and other insurance premiums. The state looks at income over a budget period of no more than 6 months. Medicaid.gov says, "Thirty-six states and the District of Columbia use spenddown programs, either as medically needy programs or as 209(b) states." It does not name them, and a spend-down program does not always cover nursing home care. See how the Medicaid spend-down works for nursing home care.

Qualified income trusts (Miller trusts)

Federal law makes an exception to its normal trust rules for a trust that holds only the person's pension, Social Security and other income. Under the law, the state receives whatever is left in the trust when the person dies, up to the total Medicaid paid for their care. This exception applies only in a state that covers the special income level group but does not cover nursing facility services for the medically needy.

CMS's State Medicaid Manual says such a trust must hold only income. No savings or other resources may be used to set it up or add to it, and including them voids the exception. Income placed in a qualifying trust is not counted when Medicaid decides eligibility. Transfer penalties do not apply to that income as long as the trust document says it will be paid out for the person's medical care, including nursing home care. The state sets how often those payments must be made. For how transfers are reviewed, see Medicaid's 5-year look-back, and for what the state may recover later, see Medicaid estate recovery and the home.

As one state's example, the Texas Medicaid handbook says its special income limit for a person "is equal to or less than 300% of the SSI federal benefit rate," and that "the use of a QIT can overcome the special income limit for MEPD eligibility for institutional or Home and Community-Based Services waiver programs." Other states may differ.

Is a spouse's income counted toward the limit?

No. While one spouse lives in a nursing home, federal law says none of the at-home spouse's income is treated as available to the resident. The limit is applied to the resident's own income, not the couple's combined income.

How much of my income goes to the nursing home on Medicaid?

All of it except certain deductions. After eligibility, federal rules say the state "must reduce its payment to an institution" by the resident's total income left after certain deductions. That remaining amount is paid toward the cost of care, and Medicaid pays the rest of the home's Medicaid rate. The deductions are:

• a personal needs allowance of at least $30 a month ($60 for a couple who are both in an institution and whose income is counted together), or more if the state sets more. See the personal needs allowance by state;
• an allowance for a spouse at home, which tops up the spouse's own income to a state standard. From July 1, 2026, the federal minimum standard is $2,705 a month ($3,381.25 in Alaska and $3,111.25 in Hawaii). The 2026 cap is $4,066.50, which can be exceeded only if a fair hearing finds exceptional circumstances causing significant financial duress or a court orders support. There is also an allowance for other family members at home;
• medical expenses not paid by a third party, such as Medicare and other health insurance premiums, deductibles and coinsurance, and necessary care recognized under state law that the state's Medicaid plan does not cover, within reasonable limits the state may set on that care.

A state may also allow an amount to keep up the home for no more than 6 months, if a doctor certifies the person is likely to return home within that time. The same basic idea applies to people who qualify as medically needy.

Example with made-up numbers: a single resident with $2,000 a month in income, in a state that uses the $30 minimum allowance, who pays a $150 monthly health insurance premium, would pay $2,000 − $30 − $150 = $1,820 a month toward care. Real amounts depend on the state's allowance and the person's own costs.

Does the nursing home income limit change every year?

Yes. CMS says certain Medicaid income standards are adjusted every year based on the SSI federal benefit rate, which goes up whenever Social Security benefits get a cost-of-living increase. The $994 rate for 2026 reflects a 2.8% increase that SSA announced on October 24, 2025. Federal law bases each increase on prices in the quarter ending September 30. The federal maximum for the income cap is 300% of the SSI rate in effect when care is provided.

For 2027: On October 14, 2026, SSA announced a 3.6% increase that becomes effective January 2027. SSA lists the 2027 SSI federal amount as $1,029 a month for one person and $1,544 for a couple. Three times $1,029 is $3,087 a month. CMS confirms each year's income cap figure in its SSI and Spousal Impoverishment Standards chart, and each state decides its own level.

Where do you find your state's limit and apply?

Your state Medicaid agency sets the limit, decides which route applies, and takes applications.

To see which homes in an area take Medicaid, use nursing homes near me, search by name, city or ZIP code on the nursing home search page, or read how to find nursing homes that accept Medicaid.