Medicaid and long-term care: the basics
Medicaid pays for long-term care for many people who qualify. This guide explains what it can cover, where care can happen, protections for a spouse, and how to apply.
Last reviewed October 27, 2026
General information only. This guide is not medical, legal or financial advice. Talk with a physician, and with an elder-law or financial professional where money or legal papers are involved, about your own situation.
What Medicaid can cover
Medicaid can pay for long-term services and supports, including help with daily activities, for people who meet their state's income, asset and care-need rules.
Nursing home or care at home
Medicaid covers nursing home care for people who qualify. Many states also use home and community-based services (HCBS) programs to pay for care at home, in adult day programs or in some residential settings.
Protections for a spouse at home
When one spouse needs long-term care and the other stays at home, federal spousal impoverishment rules let the spouse at home keep some income and assets. The protected amounts change each year.
PACE
PACE (Programs of All-Inclusive Care for the Elderly) brings medical care and support services together for people who would otherwise need nursing home care, so they can keep living in the community. It is offered only in some areas.
Applying through your state
Each state runs its own program within federal rules, so eligibility, covered services and waiting lists differ. Start with your state Medicaid agency, and keep copies of everything you send.
Frequently asked questions
It varies. Medicaid covers nursing home care for people who qualify. Coverage of assisted living services depends on the state and is often provided through home and community-based programs, sometimes with waiting lists.
Federal rules protect some income and assets for the spouse who stays at home, so they are not left without means. The amounts are set each year; your state Medicaid agency can tell you the current figures.
Apply through your state Medicaid agency. Rules on income, assets and look-back periods are detailed, so many families talk with the agency or an elder-law professional first.
Sources
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