The Alaska Medicaid income limits run on a hard ceiling, but the state hands a nursing-home resident the highest spending money in the country: a $200 monthly personal needs allowance. That combination shapes everything that follows.
This guide walks through the 2026 income and asset rules for long-term-care Medicaid in Alaska: the $2,000 asset cap, the $2,982 income limit and the Miller Trust that catches anyone over it, what a nursing-home resident keeps, what a spouse at home is protected from, and how to apply through the Alaska Division of Public Assistance.
The $2,000 asset limit
Alaska holds to the traditional federal asset standard. A single applicant for nursing-facility or waiver Medicaid is limited to $2,000 in countable assets; a married couple with both spouses applying is limited to $3,000. That's the figure that's been unchanged at the federal level since the 1980s, and unlike a handful of states that have raised their own ceiling, Alaska has not.
"Countable" is the word that does the work. Alaska, like every state, exempts a long list of assets from the count: your home (subject to an equity cap), one vehicle, household goods and personal effects, and prepaid burial arrangements. So the $2,000 applies to things like bank accounts, a second vehicle, and investments, not the roof over your head.
The 2026 home-equity limit for an exempt primary residence is $752,000. Equity above that line becomes countable for long-term-care eligibility, unless a spouse or a minor, blind, or disabled child lives in the home.
The Alaska Medicaid income limits and the Miller Trust
For nursing-facility care and home-and-community-based waiver services, Alaska sets the 2026 income limit at $2,982 per month, equal to 300% of the SSI Federal Benefit Rate of $994.
Here is where Alaska parts ways with spend-down states like Illinois. Alaska is an income-cap state: there is no "spend the excess on medical bills" path. An applicant whose gross monthly income is above $2,982, even by a dollar, is over the cap and cannot qualify for long-term-care Medicaid on income alone.
The fix is a Qualified Income Trust, commonly called a Miller Trust. It's an irrevocable trust that the applicant's excess income flows into each month. Money in the trust no longer counts against the income cap, and it's spent down under tight rules (toward the patient's care, the spousal allowance, and certain medical costs), with the state named as remainder beneficiary on the applicant's death.
The trust has to be set up correctly to do its job, so an elder-law attorney is worth the cost here. A trust drafted wrong, or funded in the wrong month, can blow the eligibility it was meant to secure. For the broader toolkit, see our guide to Medicaid planning strategies.
Long-term care and the Alaska Medicaid income limits: the $200 allowance
When Alaska Medicaid pays for nursing-facility care, the resident contributes almost all of their monthly income toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses (clothing, a haircut, a phone). Alaska sets its PNA at $200/month, the highest in the country, per the Alaska Department of Health's Cost of Care recipient guidance.
That figure is worth sitting with. Many states keep their nursing-home PNA near the old federal floor of $30 to $50; Alaska's is four to six times that. The higher cost of living in Alaska is part of the rationale, and an older codified figure of $75 is no longer the operative amount. (For the national picture on how the PNA is calculated, see our explainer on the Medicaid personal needs allowance.)
The same $2,000 asset limit applies to nursing-home applicants. And because Alaska is an income-cap state, a resident with income over $2,982 still needs the Miller Trust described above, even after they're contributing nearly all of it toward care.
The five-year look-back
Alaska reviews asset transfers made in the 60 months before a long-term-care application. Giving away money or property for less than fair market value during that window (gifting a grandchild a down payment, signing a house over to a child for a dollar) can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though you're otherwise eligible.
There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets.
Protecting the spouse who stays home
When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Alaska applies the federal figures for 2026:
| Protection | 2026 Amount | What it does |
|---|---|---|
| Community Spouse Resource Allowance (CSRA) | Half the couple's countable assets, up to $162,660; minimum $32,532 | The most in countable assets the at-home spouse may keep, on top of the applicant's own $2,000 limit. |
| Minimum Monthly Maintenance Needs Allowance (MMMNA) | $2,643.75 (eff. 7/1/2025) to $4,066.50 (eff. 1/1/2026) | The income floor the at-home spouse may keep; income can be shifted from the applicant to reach it. |
| Home-equity limit | $752,000 | Equity in the primary residence above this amount is countable for long-term-care eligibility. |
So a married couple is in a very different position from a single applicant. The community spouse can hold up to half the couple's countable assets, capped at $162,660, and keep a monthly income allowance in the federal range while the other spouse receives Medicaid-funded care.
After death: estate recovery
Like every state, Alaska runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. Federal exceptions apply, and an undue-hardship waiver exists. For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.
How to apply in Alaska
Alaska Medicaid is administered by the Alaska Department of Health, Alaska Division of Public Assistance (DPA), and eligibility is processed through the state's ARIES system. You have two main ways to apply:
- Online through the ARIES self-service portal, which handles Medicaid and other public-assistance programs together.
- By phone through the DPA Virtual Contact Center at 1-800-478-7778.
Long-term-care applicants also go through a level-of-care screening to confirm they need nursing-facility-level services. Apply even if you think you're over the income cap. Between a properly drafted Miller Trust and the spousal-impoverishment protections, many people who assume they're disqualified are not.
Frequently Asked Questions
For nursing-facility and home-and-community-based waiver Medicaid, the 2026 income limit is $2,982/month for a single applicant, set at 300% of the SSI Federal Benefit Rate ($994). Alaska is an income-cap state, so income above that line disqualifies you unless you use a Qualified Income Trust (Miller Trust).
$2,000 in countable assets for a single long-term-care applicant, or $3,000 if both spouses are applying. The home (within an equity cap), one vehicle, household goods, and a prepaid burial are exempt from the count.
Yes, for over-income applicants. Because Alaska is an income-cap state with no spend-down path, an applicant whose gross income exceeds $2,982/month must establish an irrevocable Qualified Income Trust (Miller Trust) and deposit the excess income into it each month to qualify for long-term-care Medicaid.
A Personal Needs Allowance of $200/month, the highest in the country. The rest of the resident's monthly income goes toward the cost of care, after deductions for a community spouse and certain health-insurance premiums.
For 2026, the at-home (community) spouse can keep up to half the couple's countable assets, capped at $162,660 (minimum $32,532), plus a monthly income allowance in the federal $2,643.75 to $4,066.50 range. The home is generally protected up to $752,000 of equity.
Apply online through the ARIES self-service portal, or by phone through the Division of Public Assistance Virtual Contact Center at 1-800-478-7778. Long-term-care applicants also complete a level-of-care screening.
Learn More
- Medicaid Planning Strategies
- How Medicaid Estate Recovery Works
- The Medicaid Personal Needs Allowance, Explained
Find personalized help working through Alaska Medicaid eligibility and the Miller Trust question for your family at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.