Medicaid for nursing home and home care in Oklahoma

Who qualifies

You must live in Oklahoma, be a U.S. citizen or eligible non-citizen, and be 65 or older, or blind or disabled. A medical assessment must show you need nursing home level care. Then you must meet the money rules below. The figures are from OKDHS Appendix C-1, dated July 1, 2026.

Each spouse's income is looked at on its own. Joint income is split in half.

Income over the limit: the Medicaid Income Pension Trust

If your income is over $2,982 a month but under the average monthly cost of nursing home care ($7,637 on the July 2026 chart), you can still qualify by setting up a Medicaid Income Pension Trust. This is Oklahoma's name for a qualified income trust.

• All of your monthly income must be paid into the trust. Savings and other assets cannot go in.
• You are not eligible until the trust is set up and your income has been paid in for the month.
• The trust must be irrevocable. When you die, the state gets what is left in it, up to what SoonerCare paid for you.
• Money in the trust can be used only for your care costs and a small trustee fee. Other uses can be treated as a gift and cause a penalty.
• For skilled nursing care that will last more than 30 days, OKDHS says the trust must be set up and funded by the 31st day in care.

What counts and what does not

Income. Pensions, Social Security, royalties, rent, interest and other income count. OKDHS asks for proof of both gross and net income.

Assets that count. Bank accounts, cash, stocks, extra land and other property you could turn into cash. Items kept as an investment, such as unworn jewelry or collectibles, also count.

Assets that do not count:

• Your home, if you plan to go back to it within 12 months, or if your spouse, a minor child or a disabled child lives there. Your equity must be under the home equity limit.
• One vehicle.
• Household goods and personal effects.
• Burial spaces for you, your spouse and close family.
• Burial funds of up to $1,500 each for you and your spouse, kept separate and marked for burial.
• Life insurance, if the total face value of all your policies is $1,500 or less.
• An irrevocable prepaid funeral contract.

Gifts and transfers. OKDHS looks back five years before you apply. Giving away assets, or adding someone's name to property, without getting fair value can lead to a period when SoonerCare will not pay for nursing home care.

If your spouse stays at home

Oklahoma adds up everything the couple owns, no matter whose name it is in. The spouse at home keeps half, but not less than $32,532 or more than $162,660. If the spouse's half is below the minimum, more can be moved to them. That amount must be legally moved into the spouse's name within one year.

The spouse at home can also get part of your income. The amount is the income standard of $4,067 a month minus the spouse's own gross income. Extra amounts can go to a minor child, parent or sibling who lives with the spouse.

What you pay toward your care

In a nursing home, you keep $75 a month for personal needs. Money for your spouse and family, and health insurance premiums you pay (including Medicare premiums), are also taken off. The rest of your income goes to the nursing home each month. SoonerCare pays the remaining cost.

Programs that pay for care

Nursing facility care

SoonerCare pays for care in a nursing home that takes Medicaid, if a medical assessment shows you need nursing supervision and daily help.

ADvantage waiver (home and community care)

For people 65 and over, and adults 19 to 64 with physical disabilities, who need nursing home level care but want to live at home or in assisted living. It can pay for case management, personal care, skilled nursing, home-delivered meals, medical supplies, prescriptions, home changes, adult day health, assistive technology and assisted living. In ADvantage assisted living, you keep up to $1,491 a month for your own needs.

How to apply

1. For a nursing home: tell the nursing home at admission that you want SoonerCare. You do not need to apply before you move in. The nursing home sends forms to OKDHS. Contact OKDHS right away too.
2. For ADvantage: apply online through the OKDHS "Apply for In-Home Assistance" portal, or call the Medicaid Services Unit at 1-800-435-4711 or 918-933-4900 to apply by phone. Before you start, pick a home care agency and a case management agency in your county using the provider search tool, because you will need them for the assessment call. Mail: PO Box 25352, Oklahoma City, OK 73125-9975.
3. By phone or in person: call the OKDHS Virtual Eligibility Center at 405-522-5050, or visit a Human Services Center.
4. Send proof: upload through FastPass at okdhslive.org, fax 405-669-4102, or mail to Oklahoma Human Services, P.O. Box 25352, Oklahoma City, OK 73125.

Documents to have ready:

• Social Security, Medicare and other health insurance cards, photo ID and proof of citizenship
• Proof of all income, gross and net
• Bank, investment and safe deposit box records for the past 60 months
• Deeds, mortgage statements and mineral rights papers
• Vehicle titles and amounts owed
• Life insurance, burial and cemetery plot papers
• Records of any gifts or transfers in the past 60 months
• Power of attorney or guardianship papers

OKDHS does not post a set decision time. Ask the worker when you apply.

After you apply

• Report changes in income, assets, address or marital status to OKDHS.
• Appeals: If you disagree with a decision, ask for a hearing in writing right away. OKDHS and Oklahoma Health Care Authority rules give 30 days from the date of the notice for medical program decisions. Either spouse can also ask for a hearing about the spouse's share of assets or income.
• Estate recovery: If you got long-term care at 55 or older, the state may seek repayment from your estate after you die. It does not collect while a spouse, a child 20 or younger, or a disabled child survives. If you stay in a nursing home and are not expected to go home, the state may place a lien on your home, but not while a spouse, minor child or disabled child lives there.

Common mistakes

• Waiting to set up the trust. If your income is over the limit, eligibility does not start until the Medicaid Income Pension Trust exists and your income is paid into it.
• Using the older home equity figure. The July 2026 chart lowered the home equity limit to $752,000.
• Missing records. You need 60 months of bank records. Start gathering them early.

Free help

• Senior Info-Line (Area Agencies on Aging): 1-800-211-2116
• Medicaid Services Unit (ADvantage): 1-800-435-4711
• OKDHS: 405-522-5050
• Medicare Assistance Program (SHIP): 800-763-2828, for questions about how Medicare and SoonerCare work together

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

Phone numbers: Free help lines for Oklahoma agencies

Check what you may qualify for