Medicaid for nursing home and home care in Nevada

Who qualifies

You must be 65 or older, or blind or disabled, live in Nevada, and be screened and approved as needing long-term care. For nursing home Medicaid, you must be in the facility for at least 30 days in a row, or a doctor must say you are likely to stay that long.

The income limit is 300% of the federal SSI payment. For a married person applying, DSS uses half of the couple's combined gross income.

If your income is over the limit: a qualified income trust

Nevada allows a qualified income trust (also called a Miller trust). You put the income that is over the limit into the trust each month. The rules:

• The trust must be irrevocable.
• Only your income (such as Social Security or a pension) can go into it. You cannot put savings in it.
• The money must be spent by the month after it goes in. It cannot build up.
• The trust cannot pay guardian, lawyer or trustee fees.
• When you die, the state gets what is left, up to what Medicaid paid for your care.

If a trust does not meet the rules, you get a denial notice and have 90 days to ask for an undue hardship exception.

What counts and what does not

• Not counted: the home you live in (up to the equity limit), and the other items the Medicaid rules exclude.
• Counted: cash, bank accounts, stocks and bonds, other property and most other savings.
• Home equity: If the equity in your home is more than $752,000, Medicaid will not pay for long-term care.
• Gifts and transfers: Giving away money or property to qualify can make you wait for coverage.

Your share of the cost (patient liability)

Once you qualify, most of your income goes toward your care. DSS starts with your gross monthly income and subtracts, in this order:

1. a personal needs allowance for you (the amount goes up each year; ask DSS for the current figure),
2. an allowance for your spouse at home, if any,
3. an allowance for a dependent child, parent or brother or sister who lives with your spouse,
4. health insurance premiums and some medical costs.

What is left is what you pay the nursing home each month. Medicaid pays the rest.

If you are married

Nevada gives the spouse at home the most federal law allows, without a court order.

• Savings: The spouse at home keeps up to $162,660 of the couple's countable assets in 2026. Nevada automatically allows the federal maximum.
• Income: Nevada uses the federal maximum monthly needs standard of $4,066.50 in all cases. If the spouse at home has less income than that, part of your income can go to them to make up the difference.

What Medicaid pays for

Nursing home care

Medicaid pays the nursing home after your share of cost. Coverage can start on the first day of the month you entered the facility, once all rules are met. Medicaid can also cover up to three months before the month you apply.

Home and Community Based Services Waiver for the Frail Elderly

This waiver helps people 65 and over who need nursing home level care stay at home or in a group setting. The Aging and Disability Services Division (ADSD) runs it. Services can include:

• case management: a professional checks your needs, arranges services and keeps track of them,
• homemaker help: meals, light housekeeping, laundry and shopping,
• chore help with a task that would make your home unsafe if left undone,
• adult day care for 4 or more hours a day on a regular schedule,
• adult companion care for supervision and company at home,
• an emergency call button if you live alone or are alone for long periods,
• respite care when your main caregiver needs a break,
• augmented personal care: 24-hour help in a licensed group home or assisted living facility, beyond what the facility must provide.

You must also meet the Medicaid financial rules above, including the income limit or a qualified income trust.

How to apply

1. Apply for Medicaid at accessnevada.nv.gov. Its pre-screening tool ("Do I Qualify for Medical Assistance?") tells you where to send your application. On paper, use the Application for Assistance (MAABD-SNAP) from the DSS website. You can also call DSS at 775-684-7200 (Northern Nevada), 702-486-1646 (Southern Nevada) or 800-992-0900 toll-free, or apply at a DSS office.
2. Get screened for level of care. You must be screened and approved as needing long-term care.
3. For care at home, fill out ADSD's OCL Program Application and send it to your nearest ADSD office. You, a caregiver or a community partner can fill it in. Or call your ADSD regional office and give the information by phone. After ADSD gets a signed application, an intake case manager contacts you to work out which services and program fit you best.
4. Send proof of income, bank accounts and other assets, and any trust papers.

After you apply

• Report changes in income, assets or where you live to DSS.
• Watch for scams: DSS staff will never call you about medical records, benefits or prescriptions. Hang up on suspicious calls.
• Renewals: DSS will contact you when it is time to renew. Answer by the date on the letter.
• Appeals: If you are denied or disagree with your share of cost, you can ask for a fair hearing. Follow the deadline on your notice.
• Estate recovery: After a Medicaid member who was 55 or older, or lived in a medical facility, dies, Nevada may seek repayment from the estate. It will not collect while a spouse, a child under 21, or a blind or disabled child is living. Nevada may place a lien on a home the member owned, but nothing is collected until the home is sold. Survivors can ask for a hardship waiver within 30 days of getting the hardship papers. Estate recovery unit: 775-687-8416 or [email protected].

Things people miss

• Income over the limit does not end your chances. A qualified income trust can make you eligible.
• The spouse at home does not need a court order to keep the maximum allowed.
• A doctor's statement can get your application processed before you have been in the nursing home for 30 days.

Free help

• Nevada Medicare Assistance Program (MAP): free Medicare counseling, 800-307-4444.
• Nevada Care Connection: Nevada's Aging and Disability Resource Centers, at nevadacareconnection.org.
• ADSD: adsd.nv.gov.

See also paying for a nursing home, Medicare and all benefits in Nevada.

Phone numbers: Free help lines for Nevada agencies

Check what you may qualify for