You apply for Nevada Medicaid long-term care online through Access Nevada, or on the paper aged, blind, and disabled application you mail in. To qualify, your gross monthly income must be at or below the 2026 income cap of $2,982, and an applicant over that cap needs a qualified income trust (commonly called a Miller Trust) to qualify for Nevada Medicaid long-term care at all, because none of the aged, blind, and disabled categories Nevada publishes is a medically needy spend-down category. This guide walks through each application channel, the documents you will need, how long a decision takes, and how to appeal a denial.

In This Guide

Before You Apply: Do You Need a Miller Trust?

Nevada is an income-cap state. Its aged, blind, and disabled program (MAABD) covers nursing facility residents through a category that requires gross monthly income at or below 300% of the SSI payment level, and none of the seven MAABD categories the state publishes is a medically needy spend-down category. So if your gross monthly income exceeds $2,982 in 2026, you fall outside that category unless you route the excess income into a Qualified Income Trust (commonly called a Miller Trust). The $2,982 cap equals 300% of the 2026 federal Supplemental Security Income (SSI) benefit rate of $994 per month.

A Miller Trust is an irrevocable trust authorized by federal law at 42 U.S.C. 1396p(d)(4)(B). It may be composed only of "pension, Social Security, and other income to the individual," and the trust must provide that the state receives whatever remains in it when you die, up to the total medical assistance Medicaid paid on your behalf. Each month, income above the cap flows into the trust account, and only the income that stays outside the trust counts toward the eligibility test.

One caution on the mechanics: Nevada's own procedure for establishing a Qualified Income Trust is not documented in the state's published eligibility material, so confirm the trust's exact form, timing, and funding requirements with the Division of Social Services (DSS) or a Nevada elder law attorney before you rely on them. Do not assume a trust drafted for another state will be accepted here.

If your income is at or below $2,982 per month, skip this step and go directly to the application channels below. If your income exceeds $2,982 per month, take these steps before applying.

1
Step 1

Draft the trust document

Hire an elder law attorney licensed in Nevada to prepare the Qualified Income Trust. It must be irrevocable, hold only your own income, and name the state as the remainder beneficiary up to what Medicaid pays for you.

2
Step 2

Open a dedicated trust bank account

Set up a checking account in the trust's name, not your personal account, so the excess income has a place to flow each month.

3
Step 3

Confirm the timing with DSS

Ask the Division of Social Services what it needs to see, and when, for the trust to be treated as effective for the months of coverage you are requesting. That sequencing is not published, and getting it wrong can cost you months of coverage.

Excess income that is never routed into a trust stays countable, and countable income above the cap puts you outside the category. Your asset level and your level of care do not change that.

For the full income and asset eligibility standards, see our Nevada Medicaid eligibility and income limits guide.

How to Apply for Nevada Medicaid

Two agencies share this work. The Nevada Health Authority (NVHA), created in the 2025 legislative session by Senate Bill 494, offers Medicaid through its Nevada Medicaid division, and the Division of Social Services (DSS) determines eligibility, including for MAABD. If a letter you are holding or a third-party page names some other Nevada agency, work from the two state sites linked above, which are the current ones.

Rather than pointing every applicant at one form, DSS routes you through a pre-screening step. Access Nevada carries a "Do I Qualify for Medical Assistance?" button that opens a pre-screening tool, which gathers basic information and recommends which website is the right place to submit your medical assistance application. You can also complete the paper Application for Health Insurance and mail it to the address printed on the form.

Access Nevada (Online) Nevada's online benefits portal. Start with the "Do I Qualify for Medical Assistance?" pre-screening tool, which recommends where to file, then create an account to save progress, upload documents, and track status. accessnevada.nv.gov
The Paper MAABD Application For aged, blind, or disabled coverage, use the "Application for Health Care - Medical Assistance for the Aged, Blind, or Disabled" form, posted under the Applications and Forms menu on the state benefits site, and mail it to the address on the form. dwss.nv.gov
Nevada Medicaid by Phone The Nevada Medicaid Administration Office in Carson City answers program questions. Good for confirming what the income trust requirement means for you before you file. 775-684-3676 (out of state: 1-800-992-0900)

Whichever channel you use, you will be asked about the type of coverage you need. Select the option that fits your situation: nursing-facility care, home and community-based services, or regular Medicaid. If you are applying for a parent or spouse, indicate your role as an authorized representative during the flow.

What Happens After You Apply

After DSS receives your application, a caseworker reviews it. For nursing-facility and HCBS-waiver applications, the review covers income, assets, and level of care.

Level-of-care assessment. You must meet a nursing-facility level of care to qualify for long-term-care Medicaid. This clinical assessment is handled separately from the financial eligibility review, and both must pass before benefits are approved.

Document requests. DSS sends a notice listing the documents needed to verify your application. Respond by the deadline on the notice. Failing to respond typically results in a denial that you would then have to appeal.

Processing timeline. Federal rule 42 CFR 435.912(c)(3) caps how long a state agency may take to decide an application: no more than 45 days for most applicants, and no more than 90 days for an applicant who applies for Medicaid on the basis of disability. These are ceilings on the agency, not a schedule you should plan around and not a promise of a decision by that date; the same rule allows the agency more time in the unusual circumstances it lists, such as a delay caused by the applicant or by an examining physician. The clock runs from the date of application. Which of the two caps governs you depends on the basis you applied under, not on how complicated your file turns out to be: an older applicant who applied on age is on the 45-day cap even though a long-term-care review pairs the financial workup with a level-of-care assessment. So if you applied on age and day 46 arrives with no answer, DSS is already past its limit and it is reasonable to call. Responding to every document request promptly keeps you from adding delay of your own.

Benefits start date and backdating. Federal law requires Medicaid to cover services furnished in or after the third month before the month you applied, if you would have been eligible at the time those services were furnished. That three-month retroactive window is the federal default through 2026. Under Section 71112 of Public Law 119-21, for applications filed on or after January 1, 2027, the retroactive window shortens to two months before the application month for most enrollees (and one month for the Medicaid expansion adult group).

Documents You'll Need

Gathering paperwork before you apply reduces back-and-forth with DSS and helps the review move faster.

Identity and citizenship:

  • Social Security card or award letter
  • U.S. birth certificate, passport, or Certificate of Naturalization
  • State-issued photo ID or Nevada driver's license
  • Medicare card, if enrolled

Income:

  • Social Security benefit letter for the current year
  • Pension and retirement distribution statements
  • Other monthly income statements such as annuities, VA benefits, or rental income
  • If establishing a Miller Trust: the signed trust document and bank account information

Assets:

  • Bank statements for all accounts (checking, savings, CDs) for at least the past three months
  • For nursing-facility or HCBS-waiver applications, up to 60 months of financial records may be reviewed for transfer violations
  • Retirement account statements (IRA, 401(k)) if not already in payout status
  • Life insurance policies (face value and cash surrender value)
  • Vehicle registration
  • Property deed and recent tax assessment for your primary residence

Medical:

  • Primary care physician name and contact
  • Recent hospital or skilled-nursing-facility records if you are already in care
  • Medicare Explanation of Benefits or insurance card

What You Keep: The Personal Needs Allowance

Once a Nevada Medicaid recipient moves into a nursing facility, nearly all income goes toward the cost of care. The exception is the Personal Needs Allowance of $154 per month, which the resident keeps for personal expenses such as clothing, toiletries, and incidentals. The rest of the resident's income is applied to the facility as patient liability.

Nevada's $154 Personal Needs Allowance is set above the federal floor of at least $30 per month for an institutionalized individual.

Spousal Protections

If one spouse applies for long-term-care Medicaid while the other stays at home, federal spousal impoverishment rules protect the at-home (community) spouse.

For 2026, the federal Community Spouse Resource Allowance runs from a minimum of $32,532 to a maximum of $162,660, and each state elects a standard within that range. Nevada elects the top of the range: its Medical Assistance Manual states that Nevada "automatically allows the community spouse the maximum federal spousal resource standard," so Nevada is a maximum-standard state rather than a half-the-assets state. For income, the community spouse's Minimum Monthly Maintenance Needs Allowance is $2,705.00 per month effective July 1, 2026, and the maximum Monthly Maintenance Needs Allowance is $4,066.50 per month. A given couple's allowance falls somewhere in that range. These protections prevent the at-home spouse from being impoverished by the cost of the institutionalized spouse's care.

Asset Transfer Rules and the Look-Back Period

Nevada applies a 60-month (five-year) look-back period to asset transfers. This is not a state option Nevada chose: 42 U.S.C. 1396p(c)(1) requires every state plan to apply it to assets disposed of on or after February 8, 2006. DSS reviews financial records going back 60 months from the date of application for uncompensated transfers such as gifts, sales below fair market value, or transfers into certain trusts.

A disqualifying transfer creates a penalty period during which Medicaid will not cover nursing-facility costs. The penalty length is calculated by dividing the transferred amount by the state's average monthly private-pay nursing-facility cost, and for transfers on or after February 8, 2006 the penalty begins on the later of the transfer date or the date you are otherwise eligible and receiving institutional-level care.

Federal law at 42 U.S.C. 1396p(c)(2)(D) allows an undue-hardship waiver when imposing the penalty would deprive the applicant of medical care or the necessities of life. Federal law also exempts some transfers from the penalty altogether. An elder law attorney can advise on whether a past transfer may trigger a penalty, whether it falls in an exempt category, and whether a hardship waiver is worth requesting.

For a broader overview of Medicaid planning tools, see our Medicaid planning strategies guide.

The Home Equity Limit

Home equity above a state's limit makes an applicant ineligible for long-term-care services. For 2026 that limit is $752,000 unless the state elects a higher amount, up to a maximum of $1,130,000.

Confirm Nevada's operative figure with DSS before you rely on any number. Nevada's Medical Assistance Manual F-100 still prints $713,000, which is below the $752,000 federal minimum for 2026, and the same manual prints an institutional income-limit example well below the current federal cap, so at least some of its dollar figures have not been rolled forward. If your home equity is anywhere near either figure, ask DSS in writing which limit it is applying to your application rather than planning around the published manual.

Estate Recovery

Nevada participates in the federally required estate recovery program. Under 42 U.S.C. 1396p(b), when someone who was 55 or older received Medicaid-paid nursing-facility, home and community-based, or related hospital and prescription drug services dies, the state must seek adjustment or recovery from that person's estate, subject to the federal exceptions and to an undue-hardship waiver the agency has to make available. Those exceptions turn on who survives the recipient, and some of them delay recovery rather than cancel it, so do not assume a home is permanently safe because a family member is living in it. Our guide on Medicaid estate recovery walks through how the exceptions and the hardship waiver work.

If Your Application Is Denied

DSS must send a written notice explaining the reason for any denial, and you have the right to appeal. Our guide to Nevada Medicaid appeals and fair hearings walks through the process step by step.

Read the deadline off your own notice. Under 42 CFR 431.221(d), the agency must allow a reasonable time, not to exceed 90 days from the date the notice of action is mailed, to request a fair hearing. The 90 days is a ceiling on the state, not a floor you are guaranteed: a state may set a shorter window, and a shorter window is permitted and fully enforceable against you. So the deadline that governs you is the one printed on your notice of action, which may be well short of 90 days. Do not assume you have three months.

How to appeal. Submit the request in writing, specify the decision you are appealing, and say why you believe it is incorrect. Follow the filing instructions printed on the notice itself.

What happens at the hearing. A hearing officer who was not involved in your original case reviews the record. You may present documents, testimony, and argument, and an attorney or other representative may appear with you. The hearing officer issues a written decision.

If the denial was for income over the limit. A denial based on excess income can often be resolved by establishing the income trust and reapplying, rather than by winning the appeal. Ask DSS how the trust interacts with the months you are trying to cover before you choose between appealing and refiling.

Free legal help. Nevada Legal Services provides free legal assistance to qualifying low-income Nevadans, including help with Medicaid appeals. You can find your nearest office through their statewide intake line.

Frequently Asked Questions

Can I apply for Nevada Medicaid online?

Yes. Start at Access Nevada and use the "Do I Qualify for Medical Assistance?" pre-screening tool, which recommends which site is the right place to submit your medical assistance application. Creating an account lets you save your progress, upload documents, and track status. If you would rather file on paper, the aged, blind, and disabled application is posted under the Applications and Forms menu on the state benefits site and mailed to the address on the form.

What is the income limit to apply for Nevada Medicaid for nursing home care?

For 2026, the income limit is $2,982 per month, which equals 300% of the federal SSI benefit rate., It is a hard cap: none of the seven aged, blind, and disabled categories Nevada publishes is a medically needy spend-down category, so income above the cap falls outside the nursing-facility category unless it is routed into a Qualified Income Trust.

What is a Miller Trust and do I need one?

A Miller Trust (formally a Qualified Income Trust, authorized at 42 U.S.C. 1396p(d)(4)(B)) redirects income above the $2,982 monthly cap into a restricted account holding only your own income, so Medicaid counts only the income outside the trust toward eligibility. The trust must repay the state at your death up to the total medical assistance Medicaid paid for you. You need one if your gross monthly income is above the cap. Have a Nevada elder law attorney draft it, and confirm the state's form and timing requirements with DSS, which does not publish them.

How long does it take to get approved for Nevada Medicaid?

Under federal rule 42 CFR 435.912(c)(3), the determination may not exceed 45 days for most applicants, or 90 days for an applicant applying for Medicaid on the basis of disability, measured from the date of application. Those are outer limits on the agency rather than a guaranteed decision date, and the rule allows longer in the unusual circumstances it lists, such as a delay caused by the applicant or an examining physician. Which limit applies follows the basis you applied under, not whether a disability determination comes up, so a senior who applied on age is on the 45-day limit even for a long-term-care file. Responding quickly to document requests keeps your application from stalling.

What assets can I keep and still qualify?

A single applicant may keep $2,000 in countable assets, and a couple where both apply is limited to $3,000. Nevada's institutional manual excludes one vehicle without regard to its use or value, and your home unless its equity exceeds the long-term-care equity limit. Be careful with the longer exemption lists quoted elsewhere online: household goods, personal effects, and prepaid burial arrangements are commonly excluded in other states but are not on the exemption list Nevada's own institutional manual prints, so ask DSS how a specific asset is treated in your case. On the equity limit, CMS sets a 2026 federal minimum of $752,000 while Nevada's manual still prints $713,000, so confirm the operative figure before relying on either.,

Does Nevada have a look-back period for Medicaid?

Yes. Nevada applies a 60-month look-back period, reviewing financial records for the 60 months before your application date for uncompensated transfers such as gifts or below-market sales. Federal law requires it of every state plan for assets disposed of on or after February 8, 2006, so it is not a Nevada choice. Disqualifying transfers create a penalty period during which Medicaid does not pay for nursing-facility care, though an undue-hardship waiver is available when the penalty would deprive you of medical care or the necessities of life.

Your next step Start your Nevada Medicaid application in Access Nevada, or call the Nevada Medicaid Administration Office in Carson City at 775-684-3676 (1-800-992-0900 from out of state) with questions before you file.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidNevada Medicaid Eligibility and Income LimitsNevada Medicaid income limits are a hard cap, not a spend-down. See the 2026 figures, the $2,000 asset rule, and the Miller Trust that gets seniors covered. MedicaidNevada Medicaid: A Guide for Seniors and FamiliesNevada Medicaid for seniors: 2026 income cap, the Miller Trust rule, asset limits, Medicare Savings Programs, estate recovery, and how to apply through DWSS. MedicaidNevada Medicare Savings ProgramsNevada Medicare Savings Programs 2026: QMB, SLMB, and QI income and asset limits, Part B premium savings, Part D Extra Help, and how to apply through DWSS. MedicaidNevada Medicaid Spousal Impoverishment RulesNevada Medicaid spousal impoverishment 2026: CSRA up to $162,660 and MMMNA up to $4,066.50/month protect the at-home spouse when one partner needs nursing care. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidMedicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting.

Find personalized help applying for Nevada Medicaid 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.

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