The numbers behind senior Medicaid
Here's what to do, in 4 steps.
Senior Medicaid lives in a different lane than the working-age program. Here's the order I'd work in.
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Check your state's senior Medicaid rules
Senior Medicaid rules vary by state more than any other Medicaid pathway. Start with your state Medicaid agency's eligibility page and find your local Area Agency on Aging — they know the local quirks.
Time: 30 minutes Cost: Free Medicaid.gov state directory
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Gather your financial documents
Senior Medicaid uses an asset test. Pull your Social Security benefit letter, pension statements, 3-12 months of bank statements, brokerage records, property records, and vehicle registrations before you start the application. Missing documents are the #1 reason senior applications stall.
Time: 1-2 hours Cost: Free SSA benefit verification letter
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Apply through your state Medicaid agency
Senior (aged) Medicaid applications go directly to your state Medicaid agency — NOT Healthcare.gov. Healthcare.gov only handles MAGI Medicaid for working-age adults and families. Use your state's portal, paper application, or county office.
Time: 45 days for decision Cost: Free Medicaid eligibility policy
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Get free help from SHIP, AAA, or 2-1-1
If you're also on Medicare, SHIP counselors at 1-877-839-2675 help coordinate Medicare and Medicaid for free. Your local Area Agency on Aging can walk you through the senior Medicaid application. 2-1-1 routes you to local services.
Time: Same day Cost: Free SSA toll-free
Dr. Ed explains senior Medicaid
Video coming soon
Walk-through of who qualifies, what counts, and what doesn't — with the state-by-state caveats up front.
Which of these sounds more like you?
Senior Medicaid is a state-by-state puzzle. Pick the situation that sounds most like yours.
I'm 65 or older and on a fixed incomeMostly Social Security, maybe a small pension
If your monthly income is at or near the SSI federal standard (around $994/mo individual in 2026) and your savings are under $2,000, you may qualify for senior Medicaid — and in most states for SSI itself.
State matters here. Many states use limits higher than the federal floor: 100% of the Federal Poverty Level (around $1,330/mo for an individual in 2026) is common, and some states allow up to 300% of SSI for institutional care. Call your state Medicaid agency or your local Area Agency on Aging — they know the local thresholds.
I'm on SSI — am I covered?Most states say yes. Some make you apply separately.
In 32 states plus DC — the '1634 states' — SSI approval gives you Medicaid automatically through the same agency. No separate application.
A handful of states make you apply separately. Seven to nine 'Section 209(b) states' use stricter 1972-era rules. About eleven states accept SSI's medical/financial criteria but make you file a separate Medicaid application.
I own a home — does it count?Usually exempt, with limits
Your primary residence is generally exempt from the senior Medicaid asset test, up to a state-specific home equity limit. Federal law sets a floor and a ceiling on that limit (42 USC § 1396p(f)).
If you have a second property, that's countable. If you sell your primary residence, the cash from the sale becomes a countable asset. This is one of the biggest planning traps.
I have IRA or 401(k) savingsState treatment varies. A lot.
Some states count the full balance of your retirement account as a resource. Other states treat it as exempt as long as you're taking required minimum distributions (RMDs) and only count the RMD as income.
This is the #1 swing factor for middle-income seniors. The same person can qualify in one state and have a $50,000 'asset problem' in another.
I'm on Medicare and low-incomeLook at MSPs first — then full Medicaid
If you're already on Medicare, the first thing to check is whether you qualify for a Medicare Savings Program (QMB, SLMB, or QI). MSPs pay your Medicare Part B premium, and QMB also covers your Medicare cost-sharing.
If your income is low enough for full senior Medicaid, you may qualify for both — Medicare as primary, Medicaid as secondary. That's the 'dual-eligible' arrangement. SHIP counselors can walk you through which combination fits.
I might need long-term careLTC Medicaid is its own world
Regular senior Medicaid does NOT cover routine long-term care — nursing home stays, assisted living, in-home aide hours. That's Long-Term Care Medicaid, a separate pathway with stricter rules: a 5-year asset look-back, spousal impoverishment rules, transfer penalties.
LTC Medicaid planning is technical. The earlier you start, the more options you have.
I'm helping my parent figure this outBystander — here's what they'll need from you
If you're helping an aging parent navigate senior Medicaid — especially the dual-eligible combination with Medicare — your first three calls are: (1) the state Medicaid agency, (2) the local Area Agency on Aging, and (3) SHIP at 1-877-839-2675 for the Medicare side.
Gather their Social Security benefit letter, pension statements, 3-12 months of bank statements, property records, and a list of any IRAs or 401(k)s. If they want you to handle the application, you'll need a signed authorization — each state has its own form.
If your parent has dementia or capacity concerns, look into representative payee arrangements with SSA and any state-level guardianship paperwork before you start the Medicaid application — it'll save you trips back to the office.
My situation is more complicatedProbably worth a real conversation
Senior Medicaid sits at the intersection of state rules, federal Medicare coordination, and asset planning. If you're staring at a mix of: a small business interest, a recent inheritance, a spouse with very different income, a pending move to another state, or any of the long-term-care planning traps — this page won't get you all the way home.
Start with these three calls: (1) your state Medicaid agency, (2) your local Area Agency on Aging, (3) an elder-law attorney for asset questions.
Everything people ask me
Can seniors get Medicaid?
Yes. Adults 65 and older may qualify through the 'aged' Medicaid pathway, which is non-MAGI — it uses an income test and an asset test, not the MAGI rules used for working-age adults. Federal regulations are at 42 CFR § 435.520 and § 435.530. State limits and treatment of specific assets vary widely.
What's the income limit for senior Medicaid?
The federal floor for SSI-linked Medicaid is the SSI standard — about $994/mo for an individual and $1,491/mo for a couple in 2026 (verify with your state). Many states use higher limits up to 100% of the Federal Poverty Level or higher. Call your state Medicaid agency for the exact figure where you live.
What's the asset limit?
The federal floor for SSI-linked Medicaid is $2,000 individual and $3,000 couple in countable assets — unchanged since 1989. Some states use slightly higher limits. Long-term care Medicaid uses different (and stricter) rules.
Do I have to be poor to qualify?
You don't need to be destitute, but senior Medicaid is means-tested. Most readers who land here have Social Security income at or near the SSI standard, modest savings, and a primary residence. If your income is too high but your medical bills are large, the medically needy 'spend-down' pathway (in 33+ states) can still get you covered.
Does my home count as an asset?
Generally no, while you live in it. The primary residence is exempt from the senior Medicaid asset test up to a state-specific home equity limit. Federal law sets a floor and ceiling for that limit at 42 USC § 1396p(f). If you sell the home, the cash becomes a countable asset.
Does my Social Security count?
Yes — Social Security retirement, SSDI, and most other Social Security payments count as income for the senior Medicaid income test. Medicare Part B premiums withheld from your check do NOT reduce the income figure used by Medicaid; states use the gross Social Security amount.
Does my IRA or 401(k) count?
It depends on your state. Some states count the full account balance as a resource. Others exempt the account if you're taking required minimum distributions (RMDs) and count only the RMD as income. This is one of the biggest swing factors in senior Medicaid — ask your state agency or a benefits counselor before you do anything irreversible.
Can I have Medicare and Medicaid both?
Yes — it's called 'dual-eligible.' Medicare is primary, Medicaid is secondary. Medicaid pays Medicare premiums and cost-sharing for low-income beneficiaries through the Medicare Savings Programs (QMB, SLMB, QI). Dual-eligibles also automatically qualify for Extra Help with Part D drug costs. Call SHIP at 1-877-839-2675 for free help coordinating both.
Where do I apply?
Senior (aged) Medicaid applications go directly to your state Medicaid agency — not Healthcare.gov. Healthcare.gov only handles MAGI Medicaid for working-age adults and families. Your state has a portal, paper application, or county office. The Area Agency on Aging can help you submit it.
What if I'm denied?
You have the right to a fair hearing. Federal law (42 CFR § 431.220) requires states to provide a fair-hearing process. State deadlines vary — most are between 30 and 90 days from the denial notice. If you file within 10 days, you may be able to keep current benefits while the appeal is decided. Legal Aid offices help with Medicaid denials at no cost.
Programs that often pair with senior Medicaid
Most readers who land here may qualify for at least two of these. Worth checking each.
SSI
If your countable income is at or near the federal SSI standard and your assets are under $2,000 (individual) or $3,000 (couple), you may qualify for SSI — which in most states gives you Medicaid automatically.
Medicare
If you're 65 or older, you may already be on Medicare — or eligible to enroll. Most senior Medicaid recipients also have Medicare; this combination is called 'dual-eligible.'
Medicare Savings Programs (QMB / SLMB / QI)
If you're on Medicare and low-income, you may qualify for a Medicare Savings Program. These are Medicaid-administered programs that pay your Medicare Part B premium and, for QMB, your cost-sharing.
Extra Help / Low-Income Subsidy
Senior Medicaid recipients on Medicare automatically qualify for Extra Help with Part D drug costs. If you're not on Medicaid but are low-income, you may qualify for Extra Help on its own.
SNAP
If you're a senior at or near the senior Medicaid income range, you may qualify for SNAP food benefits. Many states have a streamlined seniors-and-disabled SNAP application.
LIHEAP (heating / cooling assistance)
If senior Medicaid fits your income, LIHEAP usually does too. The federal Low-Income Home Energy Assistance Program helps with heating and cooling bills.
Help me keep it straight.
Senior Medicaid rules change. State limits change. I'll send you a plain-language note when they do.
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