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 because Louisiana runs a Medically Needy program, it does not use the special income trusts other states rely on. A separate, simpler test applies if you are 19 to 64 and not on Medicare: Louisiana covers the ACA Medicaid expansion group, where you can qualify with household income below 138% of the federal poverty level, $1,836 a month for one person in 2026.1,2

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 the ways to apply.3,2

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 $994.3,4

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, may qualify 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-1040.3

Because the projected cost of facility care counts as an incurred medical expense, the spend-down is measured against the facility bill itself, one month at a time. The point is that for a facility resident, income alone does not lock you out.1

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.3

This is also why Louisiana does not use a Qualified Income Trust, often called a Miller Trust. Louisiana's eligibility manual says these trusts apply only in a state that covers people under a special income level but doesn't provide nursing-facility Medicaid to the medically needy. Louisiana used them only from July 1, 1996 through June 30, 1997, while its Medically Needy Program was terminated, and they have not applied since the program was re-implemented on July 1, 1997. If you live in a facility and your income is high, you spend it down on care rather than being locked out of the program.1 That's a meaningful difference from Florida, where an applicant over the $2,982 cap for institutional or waiver care may qualify by establishing a qualified income trust, and Texas, where an over-income applicant can establish one to reach institutional or waiver coverage.7,8

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 covers the Affordable Care Act (ACA) Medicaid expansion adult group. Per LDH, adults age 19 to 64 who don't already qualify for Medicaid or Medicare, and who meet citizenship requirements, may qualify with household income below 138% of the federal poverty level (FPL). Income is measured under Modified Adjusted Gross Income (MAGI) rules, which allow no asset test.2

LDH's Monthly Income Limits chart, effective March 1, 2026, puts the expansion limit at $1,836/month for a household of one and $2,489/month for a household of two.2 Those figures are 138% of the 2026 HHS poverty guidelines ($15,960 a year for one person, $21,640 for two), expressed as monthly amounts. HHS publishes the guidelines as annual income and leaves what counts as income to each program, so don't hold a raw paycheck up against them; Medicaid counts income under its own rules.9,2

The 138% figure 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.4,3,2

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

On the asset side, Louisiana's limits are the same figures as the federal SSI resource limits, $2,000 for one person and $3,000 for a couple.4 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.3

The word that does the work here is "countable." LDH lists the resources that usually don't count toward the limit: the home (subject to the home-equity limit), one vehicle, the cash surrender value of life insurance policies with a combined face value of $10,000 or less, paid burial spaces, and irrevocable burial arrangements. So the $2,000 is measured against what's left after those exclusions, not the roof over your head or the car in the driveway.3

The home is exempt only up to a home-equity limit, which for 2026 falls within the federal range of $752,000 to $1,130,000.3 An applicant whose equity is above the applicable limit isn't eligible for long-term-care assistance, but the limit doesn't apply at all while a spouse, a child under 21, or a blind or disabled child lawfully lives in the home, and a reverse mortgage or home-equity loan can bring the equity under it.10

The five-year look-back

Louisiana reviews asset transfers made in the 60 months before a long-term-care application.3,10 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.

Louisiana's look-back covers transfers by the applicant or the applicant's spouse, made in the 60 months before applying or at any time after. A transfer for less than fair market value is presumed to have been made to qualify for Medicaid, but that presumption can be overcome with convincing evidence that the transfer was made exclusively for another purpose. If Louisiana decides a transfer was made to qualify, the person is ineligible for payment of facility care or waiver services for a period based on the difference between what was given away and what the person got back. The monthly cost figure Louisiana divides by is not published on the pages we cite, so get it from Louisiana Medicaid rather than estimating it.11

Paying a family member for care is not automatically a penalized transfer. What matters is whether your parent received value in return and whether the family can show it, so keep records of the care and the payments, ideally under a written caregiver agreement. A payment out of a parent's account with nothing to document it is the kind that can delay eligibility later.11

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches.10 The caregiver-child exception is narrow. Federal law exempts transferring the home to a son or daughter who lived there for at least two years immediately before the parent entered an institution and who, as determined by the State, provided care that let the parent stay home. Whether that care qualified is Louisiana's call, not the family's, so deeding the house to a caregiver child is not automatically safe.11 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's monthly income, after allowed deductions, goes 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.3,6

That $45 is the resident's to keep no matter how high their income is. Most of the rest, after deductions such as Medicare premiums and any allowance for a spouse at home, goes toward the facility bill, with Medicaid covering the gap.3,6 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. LDH says a married applicant with a spouse at home can have part of the couple's countable resources protected for that spouse. The federal 2026 standards are below; LDH's sources don't say where in these ranges Louisiana sets its own amounts.3,5,10

So a married couple is in a very different position from a single applicant. Under the federal standards, the at-home spouse's protected resources can reach $162,660, or more through a fair hearing or court order, and the spouse keeps a monthly income allowance while the other spouse receives Medicaid-funded care. LDH's own asset-limit list carries a lower, undated figure, $128,640, for a married applicant in a facility with a spouse at home, so ask LDH which figure it will apply before you plan around either one. 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 spousal resource protection above.5,3

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.3,12 For how recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Louisiana

LDH lists four ways to apply: online through the Medicaid Self-Service Portal, by printing an application and mailing or faxing it as the form directs, by phone, or in person at a local Medicaid office.3 Before admission to a Medicaid-certified nursing facility, Louisiana's Office of Aging and Adult Services also needs a Level of Care Eligibility Tool (LOCET) screening and a Level I PASRR screening.13 Apply even if you think you're over the income limit: for a facility resident, income above the $2,982 limit can be spent down rather than ending eligibility, and a spouse at home can have part of the couple's resources protected.3

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.