MEDICAID GUIDE • Last updated: April 23, 2026
State Medicaid Guides for Senior Care
Independent, state-by-state coverage guides. What 51 state Medicaid programs actually pay for — nursing home care, HCBS waivers, assisted living support, spend-down rules, and how to apply.
States Covered
51
+ DC
Medically-Needy Pathway
35
of 51 states
Waivers Researched
82
senior HCBS programs
Top States for Senior Medicaid Coverage
Full rankings →
#1
A
District of Columbia
check Medically-needy pathway
check No income cap
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#2
A
Minnesota
check Medically-needy pathway
check No income cap
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#3
C
California
check Medically-needy pathway
check 2 senior waivers
check No income cap
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#4
C
New York
check Medically-needy pathway
check 3 senior waivers
check No income cap
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#5
C
Maine
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All 50 States + DC
Updated April 23, 2026| State | Grade | Program | Income Limit (indiv) | Medically Needy | Waivers | Rank | |
|---|---|---|---|---|---|---|---|
| Alabama | C | Alabama Medicaid | $2,982 | — | 1 | #17 | View → |
| Alaska | D | Alaska Department of Health, Division of Public Assistance | $2,982 | — | 2 | #44 | View → |
| Arizona | C | Arizona Health Care Cost Containment System (AHCCCS) | $2,982 | — | 1 | #15 | View → |
| Arkansas | A | Arkansas Department of Human Services | $2,982 | check | 2 | #7 | View → |
| California | C | California Department of Health Care Services | $1,836 | check | 2 | #18 | View → |
| Colorado | C | Colorado Department of Health Care Policy and Financing | $2,982 | check | 1 | #30 | View → |
| Connecticut | F | Connecticut Department of Social Services | $2,829 | check | 1 | #46 | View → |
| Delaware | D | Delaware Division of Medicaid and Medical Assistance | $2,485 | — | 2 | #45 | View → |
| District of Columbia | A | Department of Health Care Finance (DHCF) | $2,982 | check | 1 | #2 | View → |
| Florida | F | Florida for Health Care Administration | $2,982 | check | 2 | #49 | View → |
| Georgia | C | Georgia DCH | $2,982 | check | 2 | #35 | View → |
| Hawaii | D | Hawaii Med-QUEST Division | $1,530 | check | 1 | #43 | View → |
| Idaho | C | Idaho Department of Health and Welfare | $3,002 | — | 1 | #27 | View → |
| Illinois | C | Illinois Department of Healthcare and Family Services | $1,330 | check | 2 | #23 | View → |
| Indiana | C | Indiana Family and Social Services Administration | $2,982 | — | 1 | #16 | View → |
| Iowa | A | Iowa Department of Health and Human Services | $2,982 | check | 1 | #8 | View → |
| Kansas | A | Kansas Department of Health and Environment (KDHE) | $2,982 | check | 1 | #3 | View → |
| Kentucky | B | Kentucky Cabinet for Health and Family Services' Department for Medicaid Services | $2,982 | check | 1 | #10 | View → |
| Louisiana | B | Louisiana Department of Health | $2,982 | check | 3 | #13 | View → |
| Maine | C | State of Maine Department of Health and Human Services | $2,982 | check | 1 | #26 | View → |
| Maryland | F | Maryland Department of Health | $2,982 | check | 2 | #47 | View → |
| Massachusetts | D | MassHealth (Executive Office of Health and Human Services) | $522 | check | 3 | #39 | View → |
| Michigan | C | Michigan Department of Health and Human Services | $2,982 | check | 1 | #32 | View → |
| Minnesota | A | Minnesota Department of Human Services | $2,982 | check | 1 | #5 | View → |
| Mississippi | C | Mississippi Division of Medicaid | $2,982 | — | 2 | #33 | View → |
| Missouri | A | MO HealthNet Division, Department of Social Services | $1,737 | check | 1 | #6 | View → |
| Montana | C | Montana Department of Public Health and Human Services, Senior and Long Term Care Division | $994 | check | 2 | #20 | View → |
| Nebraska | A | Nebraska Department of Health & Human Services (DHHS) | $1,330 | check | 1 | #4 | View → |
| Nevada | C | Nevada Department of Health and Human Services, Division of Health Care Financing and Policy | $2,982 | — | 3 | #24 | View → |
| New Hampshire | F | New Hampshire Department of Health and Human Services | $2,982 | check | 1 | #48 | View → |
| New Jersey | F | New Jersey Department of Human Services - Division of Medical Assistance and Health Services | $2,982 | — | 1 | #50 | View → |
| New Mexico | C | New Mexico Health Care Authority | $2,982 | — | 1 | #31 | View → |
| New York | C | New York State Department of Health | $1,836 | check | 3 | #21 | View → |
| North Carolina | C | North Carolina Department of Health and Human Services' Division of Medical Assistance | $1,330 | check | 2 | #22 | View → |
| North Dakota | A | North Dakota Department of Health and Human Services | $1,197 | check | 1 | #1 | View → |
| Ohio | C | Ohio Department of Medicaid | $2,982 | — | 3 | #19 | View → |
| Oklahoma | B | Oklahoma Health Care Authority | $2,982 | — | 1 | #11 | View → |
| Oregon | D | Oregon Department of Human Services | $2,982 | — | 4 | #37 | View → |
| Pennsylvania | C | Pennsylvania Department of Human Services | $2,982 | check | 1 | #25 | View → |
| Rhode Island | C | Rhode Island Executive Office of Health and Human Services | $2,982 | check | 3 | #36 | View → |
| South Carolina | D | South Carolina Department of Health and Human Services | $2,982 | check | 1 | #38 | View → |
| South Dakota | A | South Dakota Department of Social Services | $2,982 | — | 1 | #9 | View → |
| Tennessee | D | Tennessee Bureau of TennCare | $2,982 | check | 1 | #42 | View → |
| Texas | C | Texas Health and Human Services Commission | $2,982 | — | 2 | #28 | View → |
| Utah | B | Utah Department of Health & Human Services | $2,982 | check | 2 | #12 | View → |
| Vermont | C | Department of Vermont Health Access | $2,982 | check | 1 | #29 | View → |
| Virginia | D | Virginia Department of Medical Assistance Services | $2,982 | check | 1 | #40 | View → |
| Washington | C | Washington State Health Care Authority | $2,982 | check | 2 | #34 | View → |
| West Virginia | D | West Virginia Department of Health and Human Services Bureau for Medical Services | $2,982 | check | 1 | #41 | View → |
| Wisconsin | B | Wisconsin Department of Health Services | $2,982 | check | 3 | #14 | View → |
| Wyoming | F | Wyoming Department of Health | $2,982 | — | 1 | #51 | View → |
Income limit shown is for long-term care Medicaid (usually 300% of SSI). Some states apply a hard income cap requiring Miller Trusts; others use a "medically needy" pathway that allows spend-down of excess income. Waivers counts senior HCBS waiver programs we found in each state; states often have additional non-senior waivers (I/DD, HIV, TBI) that don't apply to elder care and aren't counted here.
Who this is for (and who it isn't)
Families in the middle of the "how do we pay for Mom's care" conversation. People who've already been frustrated by lead-gen placement services and don't want to hire a Medicaid planner yet.
Not a facility finder. Not a lead-gen service. We don't collect your information, show you sponsored recommendations, or route you to a salesperson. We publish state Medicaid coverage data, waiver details, and eligibility rules so you can figure out your own path.
Methodology
Each state's data is sourced from the CMS Transparency API, the state's Medicaid agency, NCOA, and KFF. Grounded review monthly.
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