Medicaid Spend Down Calculator 2026
Calculate your countable assets, Medicaid asset limit, spend-down amount required, and monthly income vs the income cap to estimate Medicaid long-term care eligibility.
What Is Medicaid Spend-Down and Why It Matters
Medicaid is the government health program that pays for long-term nursing home care for those who meet income and asset requirements. Unlike Medicare (which pays short-term skilled care only), Medicaid covers indefinite custodial nursing home care — but you must first "spend down" your countable assets below your state's limit, typically $2,000 for a single individual. Medicaid spend-down is the process of reducing those assets through legitimate means — paying medical bills, purchasing exempt items, or pre-paying funeral arrangements — until you qualify.
The rules are complex: not all assets count. Your primary home (if you, your spouse, or a dependent lives there) is generally exempt. One vehicle is exempt. Irrevocable pre-paid funeral contracts are exempt in most states. IRAs in payout status may be exempt in some states. However, cash savings, brokerage accounts, and second properties are typically counted. Source: Centers for Medicare & Medicaid Services (CMS), medicaid.gov. Last updated: May 2026.
2026 Medicaid Asset Limits by State (10 Largest States)
| State | Single Asset Limit | Couple (Both Applying) | Income Cap |
|---|---|---|---|
| California | No limit (2024+) | No limit | No income limit |
| Texas | $2,000 | $3,000 | $2,742/mo (300% SSI) |
| New York | $15,950 | $23,400 | No income cap (medically needy) |
| Florida | $2,000 | $3,000 | $2,742/mo |
| Illinois | $2,000 | $3,000 | No income cap |
| Pennsylvania | $2,400 | $3,200 | No income cap |
| Ohio | $2,000 | $3,000 | $2,742/mo |
| Georgia | $2,000 | $3,000 | $2,742/mo |
| North Carolina | $2,000 | $3,000 | $2,742/mo |
| Michigan | $2,000 | $3,000 | No income cap |
Legal Ways to Spend Down and Protect Assets
There are several legitimate ways to spend down or protect countable assets. Medical expenses: Pay outstanding medical bills, hearing aids, dental work, glasses, and other uncovered medical costs — all reduce countable assets. Home improvements: Repairs, accessibility modifications, or renovation of your primary home (exempt asset). Pre-paid funeral: Irrevocable pre-paid funeral contracts are exempt in most states — up to several thousand dollars. Exempt items: Purchase an exempt vehicle, or convert countable assets into personal property. Medicaid Asset Protection Trusts (MAPT): Irrevocable trusts funded more than 5 years before application can shelter assets — requires a Medicaid planning attorney. Never make gifts to family members within 5 years of applying without legal advice — the look-back penalty can delay your coverage significantly. Source: medicaid.gov, elder law bar. Last updated: May 2026.