Does Medicaid cover nursing home care?
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Yes. Nursing facility care is a mandatory benefit and Medicaid is the largest payer for it, but you must meet both a medical need test and a financial test with a five-year look-back on transfers. Federal rule: mandatory.
What federal law says
Nursing facility services for adults 21 and over are on the federal mandatory list. Once a state finds that you need a nursing-home level of care, Medicaid pays the facility's Medicaid rate for room, board and nursing care, and you contribute nearly all of your monthly income toward it, keeping a small personal needs allowance.
The financial test is where most of the complexity lives. Countable assets must be below a state limit, commonly $2,000 for a single applicant, with the home, one car and personal belongings usually excluded while a spouse or dependent lives there. Transfers of assets in the five years before applying trigger a penalty period during which Medicaid will not pay.
A spouse who stays at home is protected by spousal impoverishment rules that let them keep a share of the couple's assets and income. These rules are federal, but the dollar figures are set each year and applied by the state.
Children under 21
Children needing nursing facility care are covered under EPSDT.
What to ask your state plan
- Apply before the money runs out, not after; the application can take months and coverage can be retroactive only for a limited window, which shrinks in 2027.
- Every state has a long-term care ombudsman who handles complaints about facilities for free.
- Find your state's agency, program name and phone on Medicaid by state.
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Common questions
Does Medicaid cover nursing home care?
Yes. Nursing facility care is a mandatory benefit and Medicaid is the largest payer for it, but you must meet both a medical need test and a financial test with a five-year look-back on transfers.
Does Medicaid cover nursing home care for children?
Children needing nursing facility care are covered under EPSDT.
How do I find out whether my state's Medicaid covers nursing home care?
Three places. Your plan's member handbook or benefit summary, which lists the covered services and limits; the state Medicaid agency's provider manual for the service, which is public and states the medical-necessity criteria; and the member services line on your card, which can run a coverage check for a specific procedure code. Our state pages list each agency's phone and portal.
Sources
- medicaid.gov: mandatory and optional Medicaid benefits
- medicaid.gov: 2025 reconciliation law overview
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