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.
Frequently Asked Questions
What is Medicaid spend-down?
Medicaid spend-down is the process of reducing your countable assets below your state's asset limit to qualify for Medicaid long-term care coverage. Most states require individuals to have less than $2,000 in countable assets. You spend down by paying medical care, home modifications, prepaid funeral plans, or other allowed expenses.
What assets are exempt (not counted) for Medicaid?
Common exempt assets include: your primary home (if you or your spouse or a dependent lives there), one vehicle, personal property and household goods, irrevocable pre-paid funeral plans, and term life insurance (no cash value). Rules vary significantly by state.
What is the Medicaid asset limit in 2026?
The federal floor for countable assets is $2,000 for a single individual in most states. New York allows $15,950. California has no asset limit as of 2024. Always check your state's current Medicaid rules at medicaid.gov.
What is the Medicaid look-back period?
Medicaid has a 5-year look-back period for long-term care (nursing home) applications. Any asset transfer for less than fair market value within 5 years of applying can result in a penalty period of ineligibility. Consult a Medicaid planning attorney before transferring assets.
Can I give money to my children to qualify for Medicaid?
Generally no — gifting assets within the 5-year look-back period creates a penalty period during which Medicaid will not pay for nursing home care. The penalty equals the value of the gift divided by the state's average monthly nursing home cost.
Does Medicare pay for nursing home care?
Medicare pays for skilled nursing care only for limited periods: 100% for days 1–20, partial payment for days 21–100, and nothing after day 100. Long-term custodial nursing home care (which most people need) is not covered by Medicare — that is where Medicaid comes in.