Nevada Medicaid income limits set a hard monthly ceiling for long-term-care coverage, and going over it doesn't trigger a spend-down the way it does in many states. Instead you're shut out, unless you set up a particular kind of trust. For 2026, a single applicant for nursing-home or waiver coverage must have gross income at or below $2,982 a month and no more than $2,000 in countable assets.
This guide walks through the 2026 income and asset rules for Nevada Medicaid for aged, blind, and disabled residents who need long-term care. It covers the asset limit, the income cap and the Miller Trust that gets over-income applicants in, what a nursing-home resident keeps, what a spouse at home is protected from, the five-year look-back, and how to apply through Access Nevada.
Who runs Nevada Medicaid, and who decides eligibility
Two agencies share the work. The Nevada Division of Health Care Financing and Policy (DHCFP) is the state Medicaid agency: it sets policy and pays providers. Financial eligibility for Medicaid is determined by the Division of Welfare and Supportive Services (DWSS), which is also where you file your application. When this guide refers to the income cap or the asset test, those are DWSS determinations made under DHCFP policy.
The $2,000 asset limit
Nevada holds to the long-standing federal figure: a single aged or disabled applicant for long-term-care Medicaid may keep $2,000 in countable assets, and a married couple with both spouses applying may keep $3,000. Unlike a handful of states that have raised this ceiling, Nevada has not.
"Countable" is the word that does the work. Nevada, like every state, exempts a long list of assets from the count: your home (subject to a $752,000 equity cap for long-term-care eligibility), one vehicle, household goods and personal effects, and prepaid burial arrangements. So the $2,000 applies to things like bank accounts, a second car, and investments, not the roof over your head.
The single-applicant limit is also why married couples need to read the spousal-impoverishment section below before assuming the $2,000 figure applies to them. When only one spouse needs care, a much larger asset allowance protects the spouse who stays home.
The income test: a hard cap, and the Miller Trust that gets you in
Here is where Nevada parts ways with states like Illinois or California. For nursing-facility and home and community-based waiver coverage, Nevada sets a gross income limit of $2,982 a month for a single applicant. That figure is 300% of the 2026 SSI Federal Benefit Rate of $994.
Nevada is an income-cap state. That means the limit is a cliff, not a sliding scale. An applicant whose gross monthly income is even a few dollars over $2,982 is not eligible, and Nevada does not run a medically needy spend-down program for long-term care that would let you incur medical bills down to the line. So what happens to a senior whose Social Security and pension add up to, say, $3,300 a month? They are over the cap, but their income is nowhere near enough to private-pay a nursing home that can cost three or four times that.
The answer is a Qualified Income Trust, almost always called a Miller Trust. The over-income applicant's excess income is deposited into this special irrevocable trust each month. Income that flows through the trust doesn't count toward the $2,982 cap, so the applicant qualifies; the trust then pays the income out toward the cost of care under rules the state sets, and whatever remains in it at death goes to the state up to the amount Medicaid paid. The trust is the mechanism Nevada uses instead of a spend-down. Without it, an over-income applicant is simply shut out.
A Qualified Income Trust has to be drafted correctly to be honored, and the income has to actually pass through it every month. This is not a do-it-yourself document. If your income is over the cap, talk to an elder-law attorney before applying. For the broader picture, see our guide to Medicaid planning strategies.
Long-term care: what a nursing-home resident keeps
When Nevada 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 like clothing, a haircut, or a phone. Nevada sets its PNA at $163 a month, one of the highest in the country and far above the federal floor of $30 that many states still use.
That $163 is worth knowing about, because it directly affects how much spending money a parent in a Nevada facility actually has each month. (For the national picture on the PNA and how it's calculated, see our explainer on the Medicaid personal needs allowance.)
The same $2,000 asset limit applies to nursing-home applicants. And because Nevada uses an income cap rather than a spend-down, a resident with income over $2,982 doesn't simply pay more toward care to qualify; they need the Qualified Income Trust described above.
The five-year look-back
Nevada 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, 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.
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. Nevada 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 (effective 7/1/2025) to $4,066.50 (effective 1/1/2026) | The most monthly income 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 $162,660 in assets and keep several thousand dollars a month in income while the other spouse receives Medicaid-funded care.
After death: estate recovery
Like every state, Nevada 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 Nevada
Financial eligibility is handled by DWSS, and you have three ways to apply:
- Online through Access Nevada, the state's benefits portal at accessnevada.dwss.nv.gov, which handles Medicaid, SNAP, and other assistance together.
- By phone through DWSS at 1-800-992-0900.
- In person at a local DWSS office.
Long-term-care applicants also go through a level-of-care screening to confirm they need nursing-facility-level services. If your income is over the $2,982 cap, set up the Qualified Income Trust before or alongside your application rather than after a denial, so coverage isn't delayed. And if you're married, don't assume the $2,000 figure applies to you; the spousal-impoverishment rules above often protect far more.
Frequently Asked Questions
For long-term-care coverage (nursing facility or a home and community-based waiver), the 2026 gross income limit is $2,982 a month for a single applicant, equal to 300% of the SSI Federal Benefit Rate of $994. Nevada is an income-cap state, so an applicant over that amount must use a Qualified Income Trust to qualify.
Yes, if your income is over the cap. Nevada is an income-cap state with no medically needy spend-down for long-term care, so an applicant whose gross monthly income exceeds $2,982 must route the excess through a Qualified Income Trust (Miller Trust) to become eligible. The trust has to be drafted and funded correctly each month, which is why an elder-law attorney usually sets it up.
$2,000 in countable assets for a single applicant, and $3,000 for a couple when both spouses are applying. The home (within a $752,000 equity cap), one vehicle, household goods, and prepaid burial arrangements are exempt from the count.
For 2026, the at-home (community) spouse can keep up to $162,660 in countable assets (the Community Spouse Resource Allowance, minimum $32,532) and a monthly income allowance in the federal range of about $2,644 to $4,066, depending on the effective date. The home is generally protected up to $752,000 of equity.
A Personal Needs Allowance of $163 a month, one of 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.
Learn More
- Medicaid Planning Strategies
- How Medicaid Estate Recovery Works
- The Medicaid Personal Needs Allowance, Explained
Find personalized help working through Nevada Medicaid eligibility and the income-cap rules 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.