Does Medicaid cover nursing home?
Usually covered
Yes — nursing facility care is a mandatory Medicaid benefit, room and board included, once you meet your state's long-term-care financial limits and a nursing-facility level-of-care standard.
- Covered when You meet your state's long-term-care financial limits and the nursing-facility level-of-care standard, in a Medicaid-certified facility — covered, room and board included.
- Not when Your income/assets exceed the long-term-care limits (until spend-down or qualified planning), or an asset transfer falls within the look-back period.
- Not when You don't meet the nursing-facility level-of-care standard, or the home isn't Medicaid-certified.
What flips the answer
- Covered when
You meet your state's long-term-care financial limits and the nursing-facility level-of-care standard, in a Medicaid-certified facility — covered, room and board included.
- Not covered when
Your income/assets exceed the long-term-care limits (until spend-down or qualified planning), or an asset transfer falls within the look-back period.
- Not covered when
You don't meet the nursing-facility level-of-care standard, or the home isn't Medicaid-certified.
Key facts
- Verdict
- Usually covered
- Applies to
- nursing home · Medicaid
- Covered when
- You meet your state's long-term-care financial limits and the nursing-facility level-of-care standard, in a Medicaid-certified facility — covered, room and board included.
- Not covered when
- Your income/assets exceed the long-term-care limits (until spend-down or qualified planning), or an asset transfer falls within the look-back period.
- Varies by state
- Yes
- Verified
- 2026-07-03 · 2 primary sources
Medicaid is the primary payer of long-term nursing home care in the U.S. Nursing facility services are a mandatory benefit, and — unlike Medicare — Medicaid pays for ongoing custodial care, including the room-and-board cost, once you qualify.
Eligibility has two parts. Financially, you must fall within your state's long-term-care Medicaid income and asset limits, which are stricter than regular Medicaid and come with spousal-impoverishment protections for a married applicant's spouse and a look-back period on gifted or transferred assets. Functionally, a screening must confirm you need a nursing-facility level of care.
After approval, most of your monthly income is directed to the facility as a 'patient pay amount' (you keep a small personal-needs allowance) and Medicaid covers the remaining cost. The facility must be Medicaid-certified.
Long-term-care income/asset limits, spousal-impoverishment rules, and level-of-care screening vary by state within federal guidelines.
What people typically pay
Once approved, Medicaid reimburses the facility as a single bundled payment that includes room and board, so there is no separate bill for covered nursing care. You contribute most of your monthly income as the patient-pay amount and keep a small personal-needs allowance.
Private-pay nursing home care is expensive, and costs vary widely by location and level of care. Confirm current rates directly with facilities in your area.
Costs vary widely by state, region, and facility, and the patient-pay amount depends on your individual income after allowed deductions.
How to actually get it covered
Verify you meet your state's long-term-care Medicaid income and asset limits.
Complete a level-of-care assessment confirming you need nursing-facility care.
Select a Medicaid-certified nursing home.
Apply for long-term-care Medicaid; expect an asset look-back review of past transfers.
Once approved, most income becomes a monthly patient-pay amount and Medicaid pays the balance.
Common questions
What is the asset look-back period and how does it affect approval?
States generally review financial transfers made in the years before you apply for long-term-care Medicaid. If you gave away assets or sold them below fair value during that window, you can face a penalty period during which Medicaid won't pay for the nursing home. The exact look-back window and how the penalty is calculated vary by state, so confirm the current rules where you live.
Can my spouse keep our home and income if I go on Medicaid?
Spousal-impoverishment rules let the spouse staying at home (the 'community spouse') keep a protected share of assets and an income allowance so they aren't left destitute. The primary home is often treated as an exempt asset, especially while the community spouse lives there. The exact protected amounts and rules vary by state within federal guidelines.
What is the personal-needs allowance I get to keep?
After approval, most of your monthly income goes to the facility as your patient-pay amount, but you keep a small personal-needs allowance. The allowance amount is set by each state, so check your state's current figure.
What happens if I have too much income or too many assets to qualify?
If your income or assets exceed the long-term-care limits, you may still qualify after a spend-down until you reach your state's limit, as the base entry notes. Some states use additional planning paths for excess income. The specific rules and thresholds differ by state, so it's worth confirming with your state Medicaid agency or a qualified advisor.
Does Medicaid pay if I choose any nursing home I want?
Medicaid only pays for care in a Medicaid-certified facility, so a home that doesn't accept Medicaid won't be covered even if you're otherwise eligible. The base entry confirms institutions must be licensed and certified. Confirm certification before you move in to avoid an uncovered bill.
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