Illinois Medicaid Income Limits 2026: Eligibility & Asset Rules

Illinois Medicaid uses two different eligibility tests, and which one applies to you depends on your age and situation. A working-age adult is tested under the income-based expansion pathway at 138% of the Federal Poverty Level, with no asset test at all. A senior, or someone on Medicare or SSI, is tested under the older AABD rules, which carry an asset limit, though Illinois sets that limit unusually high, at $17,500.1

This guide lays out the 2026 Illinois Medicaid income and asset limits for both pathways. It then goes deep on the senior and long-term-care rules: the $17,500 asset limit, how spend-down works, what a nursing-home resident keeps, what a spouse at home is protected from, and the Medicare Savings Programs that catch people who think they earn too much.2,3,1

In This Guide

• Which Illinois Medicaid pathway applies to you?
• The generous asset limit is the Illinois story
• Illinois Medicaid income limits for seniors: spend-down
• Long-term care: what a nursing-home resident keeps
• Protecting the spouse who stays home
• On Medicare? The Medicare Savings Programs
• After death: estate recovery
• How to apply in Illinois
• Frequently Asked Questions
• Learn More

Which Illinois Medicaid pathway applies to you?

Before the numbers, find your lane. Illinois Medicaid sorts applicants into two eligibility tracks that use different income rules and different asset rules.

You are an adult age 19 to 64 who is not on Medicare. Illinois adopted the Affordable Care Act Medicaid expansion, so adults in this group, often called "ACA Adults," are tested on income with no asset test. The income standard is 138% of the Federal Poverty Level, which for 2026 is $1,835/month for a household of one and $2,488/month for a household of two, and there is no asset test (MAGI rules forbid one).2 Eligibility is figured under Modified Adjusted Gross Income (MAGI) rules, and the 138% standard Illinois publishes already has the 5-percentage-point MAGI income disregard built into it (the underlying federal ceiling for this group is 133% of the Federal Poverty Level), so $1,835 and $2,488 are the effective monthly cutoffs, not figures to be adjusted upward a second time.2 Income will not always be the whole test, though: under a federal rule published in June 2026, this group becomes subject to a community engagement requirement once that requirement's implementation date arrives.2 Parents and caretaker relatives are also covered under MAGI rules, through FamilyCare at the same 138% standard.7 A disability does not by itself move you off this pathway; what does is being entitled to or enrolled in Medicare Part A or Part B, or already being eligible for and enrolled in another mandatory Medicaid category.2 If this is you, the rest of this guide, which covers the senior and long-term-care rules, does not apply to your eligibility test, and you can apply directly through the portal described in How to apply.

You are 65 or older, on Medicare, or covered under SSI-related blindness or disability rules. Your test is the category tied to Supplemental Security Income that Illinois calls AABD (Aid to the Aged, Blind, and Disabled). This pathway uses a lower income standard ($1,330/month for one person) but allows a generous asset limit and a spend-down option, and it is the route to long-term-care coverage.3,1 The rest of this guide is about the AABD rules.

The two are easy to mix up. The 138% expansion number is not a senior's test, and the AABD asset limit does not apply to a working-age adult on the expansion pathway.2

The generous asset limit is the Illinois story

Illinois's countable-asset limit for AABD medical coverage used to be $2,000 for one person and $3,000 for a couple. Effective May 12, 2023, it became $17,500, and that limit is unchanged for 2026.1 The $2,000 and $3,000 figures have not disappeared entirely: they are still the resource limit for AABD cash assistance, a separate program from AABD medical coverage.3

Two details people get wrong:

The limit does not double for a couple. Whether the household is one person or two, the countable-asset ceiling is $17,500. (Spousal-impoverishment rules, below, are what protect a married couple when only one spouse needs care. That is a separate and far larger allowance.)3

The $17,500 is a limit on countable assets, and not everything you own counts. Your home is protected while it is your principal residence, or a certain close relative's, though for long-term care Illinois also applies a 2026 home-equity limit of $752,000 (more on that below).1 Which other assets are left out of the count is set by IL DHS, so call its help line at 1-800-843-6154 before assuming that any one account or vehicle puts you over.3

Illinois Medicaid income limits for seniors: spend-down

Illinois sets its 2026 AABD monthly income standard at $1,330 for one person and $1,803 for a couple (100% of the Federal Poverty Level).3 The standard is compared with countable income, not gross income: for a community AABD Medical case, IDHS policy exempts the first $25 of earned or unearned income other than SSI income and contributions, so gross income up to $25 over the standard can still be at or under it.3

Here is the part that trips people up. Being over that number does not by itself disqualify you. Illinois handles income over the standard through spend-down: under IDHS policy for AABD Medical in the community, a case whose countable income is over the standard, even by $1, is enrolled in spend-down.1,8 Approval still turns on a condition. A community applicant is approved only if spend-down is met, or the case is within the standards, for at least one month of the 12-month enrollment period, or the person is on a transplant waiting list (or would be put on one). A long-term-care applicant over the standard is approved as spend-down unless they say in writing that they don't want it.3,1

Spend-down is not a formality. Your case gets a monthly spend-down amount, and Medicaid pays nothing that month until you meet it, either by giving your Family Community Resource Center medical bills or receipts that add up to that amount or, under the Pay-In Spenddown option, by paying that amount to HFS. Coverage then runs from the day you meet it through the last day of the same month, and the next month starts fresh.8

This is why Illinois does not require a Qualified Income Trust (also called a Miller Trust) for long-term care. Federal law makes that trust the route to eligibility only in income-cap states. Illinois has no such cliff: a long-term-care applicant whose income is high is approved as spend-down rather than being shut out by an income cap.1,4

Long-term care: what a nursing-home resident keeps

When Illinois Medicaid pays for nursing-facility care, the resident pays their income to the facility, after allowable deductions such as health-insurance premiums. What they keep is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses (clothing, a haircut, a phone). Illinois raised its PNA to $60/month, effective January 1, 2024, up from the long-standing $30.3,9 The $60 is a ceiling, not a top-up: a resident on SSI does not reach it, because Social Security drops an SSI recipient's income to $30 a month on entering a nursing facility.3 And a veteran with no spouse or child whose VA benefit is cut to $90 keeps that $90 in place of the $60, never both in the same month.1

For a nursing-home resident, Illinois does not apply an income cap at all: countable monthly income goes toward the cost of care after allowable deductions, so higher income means paying a larger share rather than being turned away.1 (For the national picture on the PNA and how it is calculated, see our explainer on the Medicaid personal needs allowance.)

The five-year look-back

Illinois reviews transfers of resources or income made in the 60 months before the request for Medicaid to pay for long-term care.1,10 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 will not pay for long-term-care services, even though you are otherwise eligible.10

There are legitimate exceptions (transfers between spouses, transfers to a blind or permanently and totally 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.4 If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. For the broader toolkit, see our guide to Medicaid planning strategies.

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. Illinois publishes its own 2026 standards:3,5

So a married couple is in a very different position from a single applicant: the community spouse keeps $143,172 in assets under the standard allowance (more if a fair hearing or court order sets it) and all income paid in their own name, which income diverted from the applicant lifts toward $4,066.50 a month, while the other spouse receives Medicaid-funded care.3,5 And while that spouse lawfully lives in the home, the $752,000 equity cap does not apply at all: federal law exempts the house whatever its equity. The same holds if a child under 21, or a blind or permanently and totally disabled child of any age, lives there.1,4

On Medicare? The Medicare Savings Programs

If you are on Medicare with income too high for regular AABD Medicaid but you do not need long-term care, the Medicare Savings Programs (MSPs) are usually the right door. They pay the Medicare Part B premium, and for the highest tier (QMB), the Part A and Part B deductibles, coinsurance, and copays for Medicare-covered services as well (drug-plan copays are handled through Extra Help), and they use a higher asset limit: $9,950 for one person, $14,910 for two in 2026.3,6

Enrolling in QMB, SLMB, or QI also automatically qualifies you for Part D Extra Help, the Low-Income Subsidy for prescription drug costs: federal rules deem all three groups full-subsidy eligible, so there is no second application to file. The fourth Medicare Savings Program, QDWI, does not confer Extra Help.6

A $25 income disregard applies on top of each band, so the practical cutoffs run a bit higher than the raw numbers.3 Someone who assumes they earn "too much for Medicaid" can still fall inside one of these bands, so it is worth applying rather than ruling yourself out.6 The state administers these programs through the Illinois Department of Human Services.

After death: estate recovery

Like every state, Illinois runs a Medicaid estate-recovery program. After a recipient's death, it pursues recovery when the recipient was 55 or older when they received Medicaid assistance, or was determined permanently institutionalized at any age, and was not survived by a spouse or certain other dependents.1 Under federal law, recovery waits until any surviving spouse has died, and cannot happen while a surviving child is under 21, blind, or permanently and totally disabled; every state must also offer an undue-hardship waiver.4 During life, Illinois can place a lien on the home of a nursing-home resident of any age who is not expected to return home. It cannot do so while a spouse, a child under 21, a blind or permanently disabled child, or a sibling with an equity interest who lived there for at least a year before admission lives in the home, and it must release the lien if the resident is discharged and returns home.1 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Illinois

Illinois Medicaid is run by the Illinois Department of Healthcare and Family Services (HFS), and financial eligibility is determined by the Illinois Department of Human Services (DHS).3 For the adult-expansion pathway, Illinois lists four ways to apply, set out in steps 1 to 4 below.2 Seniors and people with disabilities applying under AABD, including for nursing-home care, also apply for medical benefits through DHS; call the DHS Help Line at 1-800-843-6154 to confirm which route fits your application.1,3

If you are applying under AABD, apply even if you think you are over the limit. The asset limit is $17,500, income over the standard is handled through spend-down rather than an income cap, and, if you are on Medicare, the Medicare Savings Programs use their own income bands and a $9,950 asset limit.3,1 Spend-down is a state option, not a federal guarantee, and it is not part of the MAGI income test that applies to adults under 65 on the expansion pathway.11

Where to get help

Learn More

Find personalized help working through Illinois Medicaid eligibility 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.