How to apply for Medicaid long-term care

Applying for Medicaid long-term care is paperwork-heavy and state-specific, and small mistakes cause months of delay when a family can least afford it. Here’s the shape of the process and how to get it right.

The two tests

You must meet a financial test and a functional test. Financially, both income and countable assets must be under state limits — commonly about $2,000 in countable assets for an individual (the home, one car, and personal belongings usually don’t count). Functionally, a state assessment must confirm you need a nursing-home level of care. See your state’s exact limits.

The five-year look-back

Medicaid reviews five years of financial records for gifts or below-value transfers. Giving away money or property to qualify can trigger a penalty period of ineligibility. This is why planning ahead — ideally with an elder-law attorney — matters so much; last-minute moves usually backfire.

The documents

Expect to provide: ID and Social Security cards, proof of income (Social Security, pension, annuity statements), five years of bank and investment statements, deeds and vehicle titles, insurance policies, and burial arrangements. Gather these early — missing records are the top cause of delay.

Protecting a spouse

If one spouse needs care and the other stays home, spousal-impoverishment rules let the at-home spouse keep a protected share of income and assets — you do not have to impoverish the healthy spouse. Know these before you spend down.

Get free help

Your state’s Medicaid office, a SHIP counselor, or the Area Agency on Aging help for free. For complex estates or a spouse to protect, an elder-law attorney often saves far more than the fee. Estimate the runway first with the spend-down calculator.

This guide is general information, not medical, legal, or financial advice. Rules vary by state and change over time. For personalized, unbiased help, your Area Agency on Aging and your state’s Long-Term Care Ombudsman are free.