Medicaid & Long-Term Care

In detail

What Medicaid covers for older adults

Beyond standard health coverage, Medicaid pays for nursing facility care for eligible residents and, in most states, for home and community-based services (HCBS) through waiver programs — personal care aides, adult day programs, and sometimes home modifications. The exact HCBS menu is a state choice, so what is available at home varies enormously by state.

Medicaid also helps many low-income Medicare beneficiaries with premiums, deductibles, and cost-sharing through the Medicare Savings Programs. If you are dually eligible for both programs, coordination rules determine which pays first.

Eligibility: the two tests

Applicants generally must meet both a medical test (needing the level of care the program covers) and a financial test (income and countable assets below the state's limits). Countable assets typically exclude the home (up to an equity limit that changes yearly), one car, and personal belongings — but the details are state-specific.

The five-year look-back: when you apply for long-term care Medicaid, the state reviews asset transfers made in the previous five years. Transfers for less than fair market value can trigger a penalty period of ineligibility. This is why moving property to 'protect' it without understanding the rules often backfires — and why timing matters.

Planning and getting help

Because the rules are technical and the stakes are high — a penalty period can mean months without coverage — many families consult attorneys or advisors experienced in their state's Medicaid rules. Be cautious of anyone selling financial products as 'Medicaid planning'; get independent legal advice first.

Free help exists: every state has a SHIP (State Health Insurance Assistance Program) offering free, unbiased Medicare and Medicaid counseling, and legal aid programs help people who meet income guidelines. Applications go through your state's Medicaid agency, not the federal government.

How this varies by state

Medicaid is the most state-variable program on this site:

• Income and asset limits, and which assets are exempt.
• Which home and community-based services are covered.
• How the state treats the home, spousal protections, and estate recovery.
• Application processes, timelines, and appeal rights.

Medicaid is funded jointly by the federal government and each state, and states administer their own programs within federal guidelines. Eligibility limits, covered services, and application processes vary by state.

We publish state-specific pages only where we have genuinely verified content. Our verified state page is Florida.

• Florida — senior legal information

Who may need help with this

• Adults planning for possible future long-term care needs
• Spouses facing a nursing home admission for a partner
• Adult children helping a parent apply for benefits
• Caregivers looking for home-care coverage options
• Anyone told to 'spend down' assets without understanding the rules

Common mistakes

• Confusing Medicare with Medicaid and assuming Medicare covers long-term care.
• Gifting property to children to 'qualify' without understanding penalty periods.
• Hiding assets — the application requires full financial disclosure.
• Buying annuities or trusts marketed for Medicaid without independent advice.
• Waiting until the nursing home bill arrives to learn the rules.

Questions to ask

• What are my state's current income and asset limits?
• How does the look-back apply to transfers I have already made?
• What home-care services does my state cover?
• What protections exist for a spouse who remains at home?
• How do I appeal if my application is denied?

Official resources

These links go to government agencies and established nonprofit organizations — not to advertisers. External links open in a new tab.

• Medicaid.gov — Centers for Medicare & Medicaid Services

  Official federal Medicaid information.

• Medicare.gov — Centers for Medicare & Medicaid Services

  Official Medicare information, including what it does not cover long-term.

• SHIP Locator — State Health Insurance Assistance Programs

  Free, unbiased health insurance counseling in every state.

• Eldercare Locator — Administration for Community Living

  Local aging services by ZIP code.