Who Pays for a Nursing Home If You Have No Money?

Last updated: October 12, 2026

What Medicaid pays and who qualifies, the asset limits in Missouri, Kansas, Nebraska, Iowa, and Florida, whether a nursing home can make you leave when the money runs out, and what Medicare and the VA will and won’t pay.

What Happens If You Need a Nursing Home and Have No Money?

Medicaid can pay for it.

Nursing facility services are one of the benefits every state’s Medicaid program is required to cover.¹ Medicaid is not the same as Medicare.

To get Medicaid to pay, you have to qualify. That means your income and your countable assets have to fit your state’s rules.

Medicaid coverage can also reach back. States must make coverage start as early as the third month before the month you applied, if you got covered services during those months and would have qualified then.²

Your monthly income has its own set of rules once you’re on Medicaid.

Nursing home costs in the states I serve: Missouri, Kansas, Nebraska, Iowa, and Florida.

What Is the Asset Limit for Medicaid in Missouri, Kansas, Nebraska, Iowa, and Florida in 2026?

If You’re Single

This is how much a single person can have in countable assets and still qualify for Medicaid nursing home care:

• Missouri: $6,220.50.³
• Kansas: $2,000.²⁴
• Nebraska: $4,000.⁵
• Iowa: $2,000.⁶⁷
• Florida: $2,000.⁸ Florida’s own fact sheet also shows a $5,000 limit when the person in the nursing home has monthly income of $1,105 or less.⁹

If You’re Married and Your Spouse Stays at Home

Medicaid doesn’t make the spouse at home go broke too.

All of the couple’s countable assets get added up, no matter whose name they’re in. The spouse at home keeps a share. What’s left has to be at or under the single-person limit above for the spouse in the nursing home to qualify.²¹⁹

For 2026, the share the spouse at home keeps can’t be less than $32,532 or more than $162,660.¹¹ Here’s how each state figures it:

• Missouri: one-half of the couple’s assets²⁰, at least $32,532 and no more than $162,660.³
• Kansas: the greater of $32,532 or one-half of the couple’s countable assets, up to $162,660.²¹²⁴
• Nebraska: up to half of the couple’s combined assets, at least $32,532 and no more than $162,660.²²⁵
• Iowa: half of the couple’s assets or $32,532, whichever is greater, but no more than $162,660.⁶
• Florida: the maximum allowed under federal law, which is $162,660 for 2026.²³¹¹

Picture a couple with $200,000 saved, and one spouse goes into a Missouri nursing home.

Half is $100,000. The spouse at home keeps that. The other $100,000 has to come down to $6,220.50 before Medicaid starts paying.²⁰³

When we say it has to come down to… essentially, you’d have to spend down that money paying for your care before Medicaid would start paying the bills.

Now picture the same couple in Florida. The spouse at home can keep $162,660, and the other $37,340 has to come down to $2,000, or $5,000 if the spouse in the nursing home has monthly income of $1,105 or less.²³¹¹⁸⁹

The spouse at home keeps part of the income too. For 2026, the spouse at home can be brought up to at least $2,705 a month, with a maximum of $4,066.50.¹¹ More on what happens to income in a nursing home.

If You’re Married and Both of You Need Care

Each state handles this in its own way:

• Missouri: $12,441 for the couple when both are in care.³
• Kansas: the couple’s combined assets are counted only for the month care begins. After that, each spouse’s own assets are counted on their own, against the $2,000 single-person limit.²¹²⁴
• Nebraska: once both spouses are in care, each spouse has to get down to $4,000 or less in countable assets.²²
• Iowa: in the month you move in, both spouses’ assets are combined and held to the married couple limit. If you share a room, that continues until the seventh month, and then each spouse can be held to the single-person limit. If you live apart, each spouse is treated as a single person starting the month after you stop living together.²⁵ Iowa sets the married couple limit at $3,000,²⁷ but only while the state counts you as a couple. Share a room and that lasts through the sixth month. Separate rooms, and you’re each measured against $2,000 from the month after you stop living together.
• Florida: the rule sets the limit at $3,000 for an eligible couple.⁸ We were unable to verify whether Florida’s $3,000 couple limit applies when both spouses are in a nursing home.

Not everything you own counts toward the limit.⁴⁷ What counts, what doesn’t, and how your state treats it is a question for an elder law attorney in your state.

Picture a lifetime of saving, and the state lets you keep $2,000 of it.

It doesn’t have to go that way. Planning before a care event gives you choices that planning after one doesn’t.

One more thing to talk about with your kids while you’re healthy: what you’d want them to do if your driving ever becomes unsafe. Here’s how families handle it: What to Do If an Elderly Parent Won’t Stop Driving?

Will I Lose My House If My Husband Goes Into a Nursing Home?

Not while you’re living in it.

Federal law caps how much home equity a person can have and still get Medicaid for nursing home care. For 2026, each state’s cap falls between $752,000 and $1,130,000.¹⁰¹¹ But the cap doesn’t apply when a spouse, a child under 21, or a blind or disabled child is living in the home.¹⁰

The spouse at home also keeps a share of the couple’s savings and part of the income, as laid out above.

What happens later is a different question.

States can put a lien on the home of a Medicaid enrollee who is permanently in a nursing home. They can’t do it while a spouse, a child under 21, a blind or disabled child, or a sibling with an equity interest in the home is living there.¹²

And after death, states are required to seek repayment from the estate of an enrollee who was 55 or older, for nursing home care and related costs. They can’t do it while a spouse, a child under 21, or a blind or disabled child of any age is still living.¹²

Did you plan on the house going to your kids?

Once the spouse at home has also passed away, it may not. The state can seek repayment from the estate for what Medicaid paid, and a lien lets the state make a claim against the home.¹²¹⁰

Can a Nursing Home Kick You Out If You Run Out of Money?

A nursing home that takes Medicare or Medicaid can’t just put you out.¹⁴ Federal rules limit when it can make a resident leave.¹³

Not paying is one of the allowed reasons. But federal rules spell out what counts as not paying:¹³

• You got reasonable and appropriate notice first.
• You didn’t turn in the paperwork for Medicare or Medicaid to pay, or Medicare or Medicaid denied the claim and you refused to pay.

Which means the money running out isn’t, on its own, a reason to discharge you, as long as the Medicaid paperwork is turned in and the claim isn’t denied.

Once you qualify for Medicaid after moving in, the nursing home can only charge you what Medicaid allows.¹³

The nursing home also has to give written notice at least 30 days before a discharge in most cases, and it can’t discharge you while an appeal of that notice is pending, with limited exceptions.¹³

And it can’t ask you to promise that you won’t apply for Medicare or Medicaid.¹³

My experiences suggest a caveat with Medicaid you should consider. You’ll likely have to find a Medicaid eligible bed and that may or may not be near you. You could lose some control over where that care is handled.

Can a Nursing Home Discharge a Patient With Nowhere to Go?

The nursing home has to prepare you for the move.

Federal rules say the facility must provide and document enough preparation and orientation to make sure the transfer or discharge is safe and orderly, in a way the resident can understand.¹³

And if you appeal the discharge notice, the nursing home can’t discharge you while the appeal is pending, with limited exceptions.¹³

What Happens to the House If You Still Own It and Move Back Home?

A lien on the home goes away when you come home.

Before a state can put a lien on the home of someone in a nursing home, federal law says the state has to decide, after notice and a chance for a hearing, that the person can’t reasonably be expected to be discharged and return home.¹⁰

And if you are discharged and return home, the law says the lien dissolves.¹⁰ Medicaid.gov says the same thing: states must remove the lien when the enrollee is discharged from the facility and returns home.¹²

Is Power of Attorney Responsible for Nursing Home Bills?

Not out of their own pocket.

A nursing home that takes Medicare or Medicaid can’t require a third party to guarantee payment as a condition of letting someone in or letting them stay.¹³

What it can do is ask the person who has legal access to the resident’s money to sign the contract. That person agrees to pay the nursing home from the resident’s income and savings, without taking on personal financial liability.¹³

Picture your daughter signing the admission papers for you.

Did she just sign up to pay your bill?

No. She agreed to pay it from your money, not hers.¹³

What Happens When Medicare Stops Paying for Nursing Home Care?

You pay, or Medicaid pays if you qualify.

Medicare covers skilled nursing facility care only after a “qualifying inpatient hospital stay,” meaning a medically necessary inpatient stay of at least 3 days in a row, not counting the day you leave. In 2026:¹⁵

• Days 1 through 20: $0 a day, after the $1,736 deductible.
• Days 21 through 100: $217 a day.
• Days 101 and beyond: in Medicare’s own words, “You pay all costs.”

Part A limits that coverage to 100 days in each benefit period.¹⁵ Those are 2026 amounts, and they change every January.

For what Medicare doesn’t pay at all, see How Much Does Long-Term Care Cost Per Month?

Who Pays for Assisted Living When Money Runs Out?

Federal Medicaid money generally can’t pay the rent.

Medicaid can pay for some care services outside a nursing home through programs called home and community-based services waivers. But federal Medicaid matching money generally isn’t available for room and board, meaning the housing and three meals a day.¹⁶

The VA doesn’t pay for it either. VA lists assisted living facilities among community residential care settings, and says, “These places are not run, staffed, or paid for by VA.” VA benefits may help pay for extra services, like visits from a VA healthcare provider.¹⁷

When the rent is more than the income, the difference has to come out of savings or some other source, because federal Medicaid money generally won’t cover the rent.¹⁶

For what memory care costs, see How Much Does Memory Care Cost for Dementia?

If the place you are looking at is a continuing care retirement community, the entrance fee changes the whole picture. Related: What Happens If You Run Out of Money in a Continuing Care Retirement Community?

What Happens to Elderly People Who Can’t Afford Assisted Living?

Many end up with family help, a state program that pays for some of the care, or a move to a nursing home that Medicaid pays for.

Medicaid generally won’t pay the rent and meals in assisted living, as covered above. Some state programs pay for the care part:

• Missouri pays a monthly cash grant to eligible people in assisted living, up to $292 a month in the state’s budget figures.²⁸
• Iowa’s Elderly Waiver, for people 65 and older, can pay for assisted living services.²⁹
• Florida’s Medicaid long-term care program covers assisted living services for people who need a nursing home level of care. Space is limited, and there can be a waitlist.³⁰

Two other places to look:

• PACE. If you’re 55 or older, need nursing home level care, and live where a PACE program operates, it can cover care while you stay in the community. With Medicaid, there’s no monthly premium.³¹ Not every county has one.
• Local help. The Eldercare Locator, 1-800-677-1116, connects you to services for older adults in your area.³²

When none of that is enough, a nursing home is the place Medicaid does pay for, after savings drop to the state’s limit, shown earlier on this page.

Does the VA Pay for Nursing Home Care?

Sometimes.

VA says you may be able to get VA benefits to help pay for nursing home care, and that it depends on your income and the level of your service-connected disability (a disability that resulted from your military service).¹⁷ If you’re enrolled in VA health care, VA covers some long-term care services under its standard health benefits, and you may still owe a copay.¹⁹

There’s also Veterans Pension, which pays a higher rate with Aid and Attendance. VA publishes the maximum yearly amounts with Aid and Attendance, effective December 1, 2025:¹⁸

• Veteran with no dependents: $29,093 a year.
• Veteran with one dependent: $34,488 a year.

By the month, that math comes out to about $2,424 and about $2,874.

From December 1, 2025, to November 30, 2026, the net worth limit to be eligible for Veterans Pension is $163,699.¹⁸

Put $2,424 a month next to the cost of a nursing home.

The 2025 national median for a semi-private nursing home room was $114,975 a year.²⁶ By the month, that math comes out to about $9,581. Take away $2,424, and about $7,157 a month is still left to pay. What long-term care costs per month.

How to Avoid Giving All Your Money to a Nursing Home?

Plan before you need care, not after.

Giving money away before you apply can count against you. When someone applies for Medicaid, the program looks back 60 months, which is five years, at assets they gave away or transferred.¹⁰ More on the look-back and the other strings attached to Medicaid.

How to protect assets for Medicaid is an elder law attorney’s work, and it’s outside the scope of my licensing.

What is in my scope is the income and other solutions to help pay for long-term care.

Does your retirement income floor cover the essentials, the adventures and experiences, and the memories with the people you love?

And if a care bill showed up, how long would your money actually last?

Medicaid decides what happens after the money is gone.

Your plan decides what happens before.

None of this is a reason to live small in your healthy years out of fear.

Frequently Asked Questions

About Kurt H. Jackson

Experience: Since founding KJ Financial in 2010, Kurt H. Jackson has worked with retirees and pre-retirees across Missouri, Nebraska, Kansas, Iowa, and Florida who discovered that the retirement plan they had built around a fixed withdrawal rule was far more fragile than they realized. He has worked directly with clients coming out of the 2008 crash, and with clients who retired into the 2020 COVID drop and the inflation spike of 2021 to 2023, and he has seen firsthand what sequence of returns risk does to a withdrawal-only strategy versus a Lifestyle-First plan with a guaranteed income floor. Before founding KJ Financial, he spent 20 years as a Certified Mortgage Planner working with more than 1,000 clients on major financial commitments, giving him deep insight into how financial decisions compound over time.

Expertise: Kurt is a Retirement Lifestyle Architect and the creator of the Lifestyle-First Retirement Income Planning framework. He builds guaranteed lifetime income, which he calls Protected Lifetime Income (PLI), under both his clients’ essentials and their non-negotiables, the adventures, the experiences and the memories with those they care about. With that income floor in place, the rest of their money no longer has to pay the bills, which means it doesn’t have to be sold in a down market. He is Life and Health Insurance Licensed in MO, NE, KS, IA, and FL. His practice focuses exclusively on insurance-based, tax-optimized retirement income strategies. He does not manage investments or sell securities.

Authoritativeness: Kurt founded KJ Financial and operates MaxMyRetirementIncome.com as a dedicated educational resource for retirees. His work is grounded in peer-reviewed and independently published research, cited directly on each page. He applies that research to the practical income planning decisions retirees face every day in the states he serves.

Trustworthiness: KJ Financial is a compliance-first firm. All figures and research citations on this page are sourced from publicly available, independently published studies and are linked directly in the content. Kurt is paid by commission from the insurance company that issues the policy. Kurt H. Jackson is not a securities broker, registered investment advisor, or CPA. Guarantees rely on the claims-paying ability of the issuing insurance company.

Contact KJ Financial:
1014 E. 5th St., Maryville, MO 64468
Direct: 816.582.5532
Email: kurt@kjfinancialonline.com
Website: www.MaxMyRetirementIncome.com

Sources

1. Medicaid.gov, “Mandatory & Optional Medicaid Benefits”. Says states are required to provide all mandatory benefits under federal law, and lists nursing facility services as a mandatory benefit.
2. Code of Federal Regulations, 42 CFR 435.915(a). Says the state must make Medicaid eligibility effective no later than the third month before the month of application, if the person received covered services then and would have qualified.
3. Missouri Department of Social Services, “MO HealthNet Eligibility for Non-MAGI Programs (07/2026)”. For vendor care in a nursing facility, lists resource limits of $6,220.50 for an individual and $12,441.00 for a couple if both are institutionalized.
4. Kansas Department of Health and Environment, Medical Kansas Economic and Employment Services Manual, July 2026, section 5130 Medical Assistance. Says nonexempt resources shall not exceed $2,000 for one person and $3,000 for two or more persons in the family group.
5. Nebraska Department of Health and Human Services, Medicaid eligibility standards chart, revised May 8, 2026. Lists the Aged, Blind, and Disabled Medicaid resource limit as $4,000 for one person and $6,000 for two.
6. Iowa Department of Health and Human Services, “Nursing & Skilled Nursing Facilities”. Says an applicant for Medicaid long-term care coverage cannot have more than $2,000 after resources are split between spouses.
7. Iowa Legal Aid, “Medicaid Payment for Nursing Home Care,” last updated February 6, 2026. Says a single person’s nonexempt resources must be $2,000 or less.
8. Florida Administrative Code, Rule 65A-1.716, Income and Resource Criteria. Lists the SSI-related Medicaid resource limit as $2,000 per individual and $3,000 per eligible couple.
9. Florida Department of Children and Families, SSI-Related Medicaid Program Fact Sheet, updated July 2025. For the Institutional Care Program, says the institutional spouse’s remaining assets must not exceed $2,000, or $5,000 if monthly income is $1,105 or less.
10. Social Security Act, section 1917. Section 1917(a)(1)(B) allows a lien on the real property of a nursing facility resident only after the state determines, after notice and opportunity for a hearing, that the person cannot reasonably be expected to be discharged and return home, and section 1917(a)(3) says the lien dissolves upon discharge and return home. Section 1917(f) sets the home equity limit, lets states choose a higher amount, indexes it to inflation, and says it doesn’t apply when a spouse, a child under 21, or a blind or disabled child lawfully lives in the home. Section 1917(c) sets the 60-month look-back for asset transfers.
11. Centers for Medicare & Medicaid Services, Informational Bulletin, “Updated 2026 SSI and Spousal Impoverishment Standards,” April 27, 2026. Lists 2026 home equity limits of $752,000 minimum and $1,130,000 maximum, and community spouse resource standards of $32,532 minimum and $162,660 maximum.
12. Medicaid.gov, “Estate Recovery”. Says states must seek recovery from the estates of enrollees 55 or older for nursing facility services and related costs, may not recover while a spouse, child under 21, or blind or disabled child survives, may place liens on the property of a permanently institutionalized enrollee except when a spouse, child under 21, blind or disabled child, or sibling with an equity interest lives in the home, and must remove the lien when the enrollee is discharged and returns home.
13. Code of Federal Regulations, 42 CFR 483.15, Admission, transfer, and discharge rights. Bars requiring a third-party guarantee of payment, allows a representative with legal access to the resident’s funds to sign without personal financial liability, bars asking residents to promise not to apply for Medicare or Medicaid, defines non-payment as a discharge reason, limits charges to Medicaid-allowable amounts after Medicaid eligibility, requires 30 days’ notice in most cases, bars discharge while an appeal is pending with limited exceptions, and requires preparation for a safe and orderly discharge.
14. Code of Federal Regulations, 42 CFR 483.1(b). Says these requirements apply to skilled nursing facilities in Medicare and nursing facilities in Medicaid.
15. Medicare.gov, “Skilled nursing facility (SNF) care”. Says Medicare only covers SNF care after a qualifying inpatient hospital stay of at least 3 days in a row, not counting the day you leave. Lists 2026 costs of $0 for days 1 to 20 after the $1,736 deductible, $217 a day for days 21 to 100, and all costs for days 101 and beyond, and says Part A limits coverage to 100 days in each benefit period.
16. Code of Federal Regulations, 42 CFR 441.310(a)(2). Says federal Medicaid matching funds are not available for room and board in home and community-based waiver services, with limited exceptions, and defines board as three meals a day.
17. U.S. Department of Veterans Affairs, “VA Nursing Homes, Assisted Living, and Home Health Care,” last updated September 2, 2026. Says VA benefits may help pay for nursing home care depending on income and service-connected disability, and that community residential care settings, including assisted living facilities, are not run, staffed, or paid for by VA.
18. U.S. Department of Veterans Affairs, “Veterans Pension rates”. Lists maximum annual pension rates effective December 1, 2025, including $29,093 with Aid and Attendance for a veteran with no dependents and $34,488 with one dependent, and a net worth limit of $163,699 through November 30, 2026.
19. U.S. Department of Veterans Affairs, “Does VA cover nursing home, assisted living, or other long-term care?” Says VA covers some long-term care services under standard health benefits, a copay may apply, and other services may be paid through Medicaid, Medicare, or private insurance.
20. Missouri Department of Social Services, “Prevention of Spousal Impoverishment”. Says the spouse at home keeps one-half of the couple’s total assets, subject to a minimum and maximum. (The dollar amounts on this page are from 2018; the current amounts come from source [3].)
21. Kansas Department of Health and Environment, Medical Kansas Economic and Employment Services Manual, July 2026, section 8140. Says the couple’s combined resources are considered, the community spouse resource allowance is the greater of the minimum allowance or one-half of the couple’s nonexempt resources, not to exceed the maximum, and the institutionalized spouse is eligible if what’s left is at or under the one-person resource level.
22. Nebraska Administrative Code, Title 477, Chapter 26, section 003.01(E). Says the community spouse may reserve up to half of the couple’s combined resources, subject to a minimum and maximum reserved amount. Section 003.03(D) says that if the community spouse begins to receive institutional care, the couple would need to reduce resources so that each spouse has $4,000 or less before either is eligible for other aged, blind, or disabled Medicaid programs.
23. Florida Administrative Code, Rule 65A-1.712(4)(c). Says the community spouse resource allowance is equal to the maximum resource allocation standard allowed under federal law, or any court-ordered support, whichever is larger.
24. Kansas Department of Health and Environment, Kansas Medical Assistance Standards, F-8, 07-26. Lists the Long Term Care (nursing facility, HCBS, PACE) resource limit as $2,000 for an individual with spousal impoverishment policies applying to couples, a resource allowance minimum of $32,532 and maximum of $162,660, and a minimum monthly needs allowance of $2,705 and maximum of $4,066.50.
25. Iowa Administrative Code, 441 IAC 75.5(4)“c” and “d”. Says spouses sharing a room in a medical institution are held to the married couple resource limit until the seventh month, after which each can be held to the single-person limit, that spouses institutionalized apart are treated as individuals starting the month after they stop living together, and that in the month of entry all resources of both spouses are combined under the married couple limit.
26. Genworth, “CareScout Releases 2025 Cost of Care Survey Results,” March 2, 2026. Gives the 2025 national median cost of a semi-private nursing home room as $315 a day, or $114,975 a year.
27. Iowa Department of Health and Human Services, Employees’ Manual, Title 8: Medicaid, Chapter D: Resources, revised July 10, 2026. Says that for SSI-related Medicaid eligibility the resource limit is $2,000 for an individual and $3,000 for a married couple living together.
28. The Missouri Office of Administration’s budget page on the Supplemental Nursing Care program lists a maximum of $292 a month for assisted living residents.
29. Iowa HHS’s Elderly Waiver information packet lists assisted living services among Elderly Waiver services.
30. Florida AHCA’s long-term care program FAQs list assisted living among covered services and explain the waitlist.
31. Medicare.gov explains who qualifies for PACE and what it costs.
32. The Eldercare Locator, a service of the Administration for Community Living.

Every figure on this page was checked against its numbered source on September 17, 2026.

All figures are as of the dates shown and are for education only. Medicaid and VA rules and amounts vary by state and change. This page is not legal, tax, or Medicaid planning advice. Questions about your own Medicaid eligibility belong with an elder law attorney in your state.