The three requirements
Nursing home (long-term care) Medicaid eligibility comes down to three things, and your parent needs to meet all three: they must be a resident of the state they're applying in, their income and countable assets must fall under state-specific limits, and they must have a demonstrated functional need for long-term care — a diagnosis alone (like dementia) is not enough on its own; there has to be an assessed need for help with daily activities.
2026 income and asset limits
Nationally, a common baseline is a single applicant needing income no greater than roughly $2,982 per month and countable assets under roughly $2,000 — but this varies significantly by state. Some states set their asset limits much higher; New York, for example, allows around $33,038 for an individual in 2026. Because the gap between states can be that large, don't assume a number you read somewhere applies to your state — check directly.
What generally does not count toward the asset limit: the primary home (if the applicant intends to return or a spouse/dependent lives there), one vehicle, household furnishings, and prepaid burial arrangements up to a state-set amount.
If your parent is over the income or asset limit
Being over the limit doesn't automatically mean no Medicaid — a few common paths exist:
- Spend-down: spending excess assets on allowable, exempt items (medical expenses, home repairs, paying off a mortgage, prepaid funeral arrangements) to get under the limit.
- Qualified Income Trust / Miller Trust: used when income exceeds the limit — excess income is deposited into the trust each month so the person can still qualify. This generally needs an elder law attorney to set up correctly.
- Spousal protections: if only one spouse is applying, the non-applicant spouse is generally allowed to keep a higher asset amount and a minimum monthly income, so the whole household isn't reduced to poverty.
Improperly transferring or giving away assets to get under the limit can backfire — most states have a five-year look-back period, and transfers made below fair market value during that window can trigger a penalty period that delays eligibility rather than speeding it up.
Virginia specifics (2026)
Income limit: $2,982/month for a single applicant. Asset limit: $2,000 for a single applicant, $4,000 if both spouses are applying. If only one spouse applies, the non-applicant spouse can keep up to $162,660 in assets and is guaranteed a minimum monthly income between $2,705 and $4,066.50 depending on shelter costs. The look-back period is 60 months. The home is exempt up to $730,000 in equity. Virginia's program is called the CCC+ Waiver (Cardinal Care), and eligibility also requires meeting a Nursing Facility Level of Care via the state's Uniform Assessment Instrument.
The functional assessment
Financial eligibility is only half of it. A screening team (typically a social worker and a health department nurse) evaluates whether your parent is functionally dependent enough to need nursing-facility level care — help with bathing, dressing, eating, toileting, or mobility, plus ongoing medical or nursing needs. If your parent is in the hospital, ask the discharge planner to arrange this screening before discharge rather than after — it's much harder to schedule once they're home.