Louisiana Medicaid Income Limits 2026: Eligibility & Assets

Louisiana Medicaid sets a long-term-care income limit of $2,982 a month for 2026, and the headline number looks like a cliff. For someone already living in a long-term-care facility, it is not one. Being over that limit does not automatically shut you out of Louisiana Medicaid. For a facility resident, the state lets you spend the excess down on your care each month, and unlike many states, it does not make you set up a special trust to do it. A separate, simpler test applies if you are an adult under 65 who is not in long-term care: Louisiana expanded Medicaid, so adults age 19 to 64 qualify at or below 138% of the federal poverty level, roughly $1,836 a month for one person in 2026.

This guide walks through the 2026 income and asset rules for Louisiana Medicaid: which income test applies to whom, the $2,982 long-term-care special income limit, how the spend-down actually works, what a nursing-home resident keeps, what a spouse at home is protected from, and how to apply through the state's LaMEDS system.1,2

How Louisiana Medicaid income limits work: the $2,982 limit and spend-down

Louisiana Medicaid is run by the Louisiana Department of Health (LDH), and for long-term care it sets a Special Income Limit (SIL) of $2,982/month in 2026. That figure isn't arbitrary: it's 300% of the 2026 SSI federal benefit rate of $994.1,3

For a person who resides in a long-term-care facility, the SIL is not a hard wall. If your monthly income sits above $2,982, Louisiana does not simply tell you that you earn too much for Medicaid. Instead, the state runs a medically needy pathway: the Long Term Care Spend-Down Medically Needy Program. A person who lives in a long-term-care facility and meets every other requirement, but whose income is over the SIL, qualifies by incurring medical expenses, including the projected Medicaid rate for the facility, at least equal to the income above the limit. The rules for this live in the Louisiana Medicaid Eligibility Manual, Section H-1040.1

In practice, a nursing-home resident's care bill almost always dwarfs their income, so the spend-down is met easily once that facility cost is counted. The point is that for a facility resident, income alone does not lock you out.

Note the boundary, because it matters for planning. Louisiana's manual writes this spend-down program for people who reside in a long-term-care facility. If you are applying for a home and community-based waiver while still living at home and your income is over $2,982, ask the Louisiana Department of Health which pathway applies to you before assuming the spend-down covers your situation.1

This is also why Louisiana does not require a Qualified Income Trust, often called a Miller Trust. In strict income-cap states, an applicant even a dollar over the limit is disqualified unless they route the excess through a special trust set up for that purpose. Louisiana has no such requirement. If your income is high, you spend it down on care rather than being locked out of the program. That's a meaningful difference from income-cap states like Florida, where an applicant over the cap cannot qualify no matter how high their medical expenses are unless a Qualified Income Trust is established and funded, and Texas, where the trust is the route an over-income applicant uses to reach institutional or waiver coverage.3,4

Adults under 65: the 138% FPL expansion pathway

Everything above is the long-term-care lane. A different test applies to a working-age adult who is not seeking nursing-home or waiver care. Louisiana adopted the Affordable Care Act (ACA) Medicaid expansion (effective July 1, 2016), so adults age 19 to 64 who are not on Medicare can qualify on income alone, with no asset test.2

The standard is 138% of the federal poverty level (FPL), measured under Modified Adjusted Gross Income (MAGI) rules. For 2026, the Louisiana Department of Health sets that limit at $1,836/month for a household of one and $2,489/month for a household of two (effective March 1, 2026).2 Those figures track the 2026 federal poverty guidelines: 100% FPL is about $1,330/month for one person, and 138% of it lands near $1,836.5

This is the number calculator sites often surface on a senior's search, and it is the wrong one for someone facing long-term care. The expansion test is for the 19-to-64 adult who needs ordinary health coverage. A person 65 or older, or one applying for nursing-facility or waiver Medicaid, is measured under the aged/blind/disabled and long-term-care rules in the rest of this guide, the $2,982 special income limit and the $2,000 asset test, not the 138% FPL standard.3,1

The asset limit: $2,000 for one, $3,000 for a couple in the same facility

On the asset side, Louisiana follows the long-standing federal figures rather than the raised limits a few states have adopted. A single long-term-care or waiver applicant is limited to $2,000 in countable assets. The $3,000 couple's figure is narrower than it sounds: it is the standard for a married couple residing in the same facility, not for any two spouses who happen to apply together. When one spouse is in care and the other stays home, the applicant is held to the $2,000 limit and the at-home spouse is protected by the separate resource allowance described below.1

The word that does the work here is "countable." Louisiana, like every state, exempts a long list of resources from the count: the 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 or the car in the driveway.1

The home is exempt only up to a federally set home-equity limit, which for 2026 falls within the federal range of $752,000 to $1,130,000. Equity above that line is countable for long-term-care eligibility, though the cap doesn't apply while a spouse or certain dependents live in the home.1

The five-year look-back

Louisiana reviews asset transfers made in the 60 months before a long-term-care application.1,6 Giving away money or property for less than fair market value during that window, signing a house over to a child for a dollar or gifting a grandchild a down payment, 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. For the broader toolkit, see our guide to Medicaid planning strategies.

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

When Louisiana Medicaid pays for nursing-facility care, the resident contributes almost all of their monthly income toward the cost of care. What they keep for themselves is the Personal Needs Allowance (PNA): in Louisiana, $45/month, reserved for small personal expenses like clothing, a haircut, or a phone bill.1,7

That $45 is the resident's to keep no matter how high their income is. Everything above it (after deductions for a community spouse and certain health-insurance premiums) goes toward the facility bill, with Medicaid covering the gap.1,7 For the national picture on how the PNA is set and why it varies by state, see our explainer on the Medicaid personal needs allowance.

Protecting the spouse who stays home

When one spouse needs long-term care and the other stays in the community, federal spousal-impoverishment rules keep the at-home spouse from being left with nothing. Louisiana applies the federal framework for 2026:1,8

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets and keep thousands a month in income while the other spouse receives Medicaid-funded care. The $3,000 couple's asset limit is not the number that governs here: it is the standard for a couple residing in the same facility, so a household with one spouse in care and one at home is measured by the $2,000 applicant limit plus the resource allowance above.8,1

After death: estate recovery

Like every state, Louisiana runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, federal law requires the state to seek repayment from the estate. Recovery may be made only after the death of a surviving spouse, and only when there is no surviving child under 21 and no surviving child who is blind or permanently and totally disabled. Read the spousal protection as a timing rule rather than a permanent exemption: it defers recovery while the surviving spouse is alive, it does not cancel the claim. Every state must also have a procedure to waive recovery where it would work an undue hardship.1,6 For how recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Louisiana

Louisiana Medicaid eligibility is determined through the state's LaMEDS system, and you have three ways to start an application. Long-term-care applicants also go through a level-of-care screening to confirm they need nursing-facility-level services.1 Apply even if you think you're over the income limit. Between the spend-down pathway and the spousal protections, many people who assume they're disqualified are not.

Learn More

Find personalized help working through Louisiana Medicaid eligibility and the long-term-care spend-down 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.