Medicaid Spend-Down Calculator 2026
Medicaid long-term care has strict asset limits that vary by state — typically $2,000 to $15,750 for a single applicant. Calculate exactly how much excess wealth you need to "spend down" or convert to exempt assets to qualify for nursing home Medicaid in 2026. Per Medicaid.gov state plan limits.
What Is Medicaid Spend-Down?
Medicaid is the primary payer for nursing home and long-term care for low-income Americans — it covers approximately 62% of all US nursing home residents per Medicaid.gov data. But Medicaid has strict asset limits — typically $2,000 in countable assets for a single applicant. If you have more than the limit, you must legally "spend down" the excess on care, exempt assets, or via spousal protections before becoming eligible. The spend-down period is the time between needing care and qualifying for Medicaid — during which the applicant pays out of pocket (often $9,000-$15,000/month for nursing home care). Last updated May 2026.
2026 State Asset Limits by State
Asset limits for institutional Medicaid (nursing home) in 2026: $2,000 in most states (FL, TX, PA, OH, NJ, IL, NC, GA, MI, VA, WA, MA, AZ, MD, MN, CO, WI, MO, IN, TN, MS, AL, SC, AR, KY, OR, OK, NV, UT, KS, IA, NM, NE, WV, ID, HI, NH, ME, MT, RI, DE, SD, AK, VT, WY, ND). $3,000 in some states (CT, MN exception). $15,750-$31,175 in New York (highest in continental US for community Medicaid). California abolished the asset limit entirely in January 2024 — no asset cap for Medi-Cal eligibility. Per Medicaid.gov state plan amendments, the federal floor is $2,000, but states may raise it.
The 5-Year Look-Back Period
Medicaid examines all asset transfers in the 60 months (5 years) before the application date. Any uncompensated transfer (gifts, below-market sales, distributions to family) triggers a penalty period — months of Medicaid ineligibility calculated as transferred amount ÷ state's monthly penalty divisor (typically $9,000-$13,000/month). Giving away $50,000 in year 4 of look-back triggers ~5 months of ineligibility, during which you pay out of pocket. Per CMS rules implementing the Deficit Reduction Act of 2005, this is non-negotiable — there is no "innocent gift" exception. Proper Medicaid planning must begin at least 5 years before application. Last-minute planning (within 5 years of need) requires using exempt asset conversions, irrevocable Medicaid asset protection trusts (MAPT), or Medicaid-compliant annuities.
Exempt Assets and the Community Spouse
Not all assets count. Exempt assets include: primary residence (equity up to $730,000 in 2026, or $1,097,000 in 11 high-cost states per CMS), one vehicle, household goods, personal effects, prepaid funeral plans, and small life insurance with cash value under $1,500. For married couples where one spouse needs care, the Community Spouse Resource Allowance (CSRA) for 2026 protects up to $157,920 of joint assets for the spouse remaining at home, plus a Minimum Monthly Maintenance Needs Allowance (MMMNA) for income. Source: Medicaid.gov, CMS Long-Term Care eligibility manual, 2026 federal SSI/Medicaid figures.