Income Rules for Long-Term Care Medicaid
Income matters twice in Long-Term Care Medicaid. First, it can decide whether someone qualifies, since many states have an income limit. Second, after approval, it decides how much the person pays toward their care each month. This section explains what counts as income, what does not, the 2026 limits, and how income works for married couples.
Figures change periodically. Double-check current amounts before relying on them.
The short version
- In many states, an applicant’s income must be at or below $2,982 a month in 2026 (300 percent of the federal SSI benefit). People above that may need a Qualified Income (Miller) Trust.
- Other states have no fixed income cap for nursing home care. Instead, income must be less than the cost of care, and most of it goes toward that cost.
- After approval, a nursing home resident keeps a small personal needs allowance (from $30 to $200 a month in 2026, depending on the state). Most of the rest goes to the nursing home as patient liability.
- The spouse at home’s income is not counted toward the applicant’s eligibility, and the spouse at home may receive part of the applicant’s income. See Income for couples.
Guides in this section
| Guide | What it covers |
|---|---|
| What counts as income? | Earned and unearned income, gross vs. net, and the “name on the check” rule |
| Income that does not count (disregards) | The $20 general disregard, earned income disregards and other exclusions |
| Income limits by state (2026 chart) | Every state’s 2026 income rule for Long-Term Care Medicaid |
| Personal needs allowance | What the resident keeps each month, by state |
| Patient liability | How the monthly payment to the nursing home is figured |
| Income for couples | Whose income counts and how the spouse at home is protected |
| Business and self-employment income | Net earnings, allowed deductions and averaging uneven income |
| Rental income | How net rent is figured month by month, and what can be deducted |
| Federal poverty guidelines | The 2026 figures and where they set limits and allowances |
| Pensions, Social Security and annuity payments | Gross amounts, deductions and the effect on patient liability |
| SSI, state supplements and income | SSI rules, state supplements and what happens in a nursing home |
| Tithing, gifts received and one-time money | Gifts, refunds, inheritances, settlements and charitable giving |
Getting help
If income is over a state’s cap, or a married couple needs to protect income for the spouse at home, the details matter. A Certified Medicaid Planner (CMP) can help a family understand the options. Each state guide lists that state’s 2026 income rules.
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.