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

Last updated: September 17, 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.

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?

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

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.