Nevada Medicaid Eligibility 2026

Last Updated: January, 2026

Nevada Medicaid eligibility 2026 requires meeting specific income and asset limits based on your household size and category.

Most adults qualify at 138% of the federal poverty level ($1,799/month for individuals), while pregnant women and children have higher limits up to 205% FPL.

Quick Article Summary:

• Benefit Type: Nevada Medicaid provides free or low-cost health coverage for eligible low-income residents
• Income Limits: Adults earn up to $1,799/month; families of 4 earn up to $3,697/month under expansion
• Asset Rules: No asset test for expansion adults; $2,000 limit for nursing home and aged/blind/disabled applicants
• Look-Back Period: 60-month review for long-term care applications to prevent asset transfers
• 2026 Changes: Statewide managed care expansion now covers all 17 Nevada counties starting January 1, 2026
• Application: Apply online through Access Nevada, by mail, or in person with required income and residency documentation

This comprehensive guide breaks down exactly who qualifies for Nevada Medicaid in 2026, including major program changes affecting 75,000 rural residents, updated income thresholds for long-term care, and asset protection strategies that could save your family thousands, as part of our complete medicaid eligibility 2026 coverage for all 50 states.

What Is Nevada Medicaid and Who Runs It?

Nevada Medicaid is a joint federal-state health insurance program administered by the Nevada Division of Health Care Financing and Policy (DHCFP) and the Department of Welfare and Supportive Services (DWSS).

The program provides free or low-cost healthcare to eligible low-income residents, including specific protections for seniors, pregnant women, children, and people with disabilities.

Unlike Medicare, which primarily serves seniors regardless of income, Medicaid targets financial need while offering broader long-term care benefits that Medicare does not cover.

Nevada operates several distinct Medicaid programs under this umbrella.

Traditional Medicaid serves low-income adults and children, while the Medical Assistance for the Aged, Blind, and Disabled (MAABD) program specifically caters to vulnerable populations requiring specialized care.

For children in moderate-income households who earn too much for traditional Medicaid, Nevada Check Up (the state’s Children’s Health Insurance Program) fills the coverage gap with modest quarterly premiums.

2026 Income Limits by Eligibility Category

Understanding where your household falls within Nevada Medicaid income limits 2026 determines which program pathway fits your situation.

The state uses Federal Poverty Level (FPL) percentages that adjust annually, with 2026 limits reflecting cost-of-living increases.

Medicaid Expansion Adults (Ages 19-64)

Since Medicaid expansion criteria vary nationwide, comparing Medicaid income limits by state reveals that Nevada’s 138% FPL standard for adults aligns with most expansion states, though specific dollar amounts vary by household composition and annual federal adjustments.

No asset test applies to this category—you can own a home and savings and still qualify if your income falls below these thresholds:

For each additional person, add $632 monthly or $7,584 annually.

Pregnant Women and Postpartum Coverage

Nevada offers extended pregnancy benefits with higher income limits and 12-month postpartum coverage—a recent enhancement from the previous 60-day limit. Pregnant women qualify at up to 205% of the FPL:

Children and Nevada Check Up (CHIP)

Children face different eligibility ceilings based on age.

The state separates infants and toddlers from school-age children, with a separate CHIP program for families earning above Medicaid limits but below 205% FPL:

Children Birth to Age 5: 165% FPL ($4,420/month for a family of four)
Children Ages 6-18: 138% FPL ($3,697/month for a family of four)
Nevada Check Up (CHIP): Up to 205% FPL ($10,050/month for a family of four, though quarterly premiums apply based on sliding scale)

Long-Term Care Medicaid Eligibility (2026)

Securing coverage for nursing homes or in-home care involves stricter financial scrutiny than standard Medicaid.

These programs enforce both income caps and asset limits, plus a 60-month look-back period to prevent last-minute gifting of assets.

The 2026 updates include significant income increases reflecting the new Federal Benefit Rate.

Nursing Home Medicaid and HCBS Waivers

The income limit for single applicants jumped from $2,901 (2025) to $2,982 per month in 2026—a $81 monthly increase.

Married couples where both spouses apply can earn up to $5,964 combined.

However, nursing home residents must contribute nearly all income toward care costs, keeping only $154 as a Personal Needs Allowance for personal items.

The Community Spouse Resource Allowance (CSRA) protects the healthy spouse from impoverishment by allowing them to retain up to $157,920 in countable assets (increased from approximately $154,140 in 2025).

MAABD Medicaid for Seniors and Disabled Individuals

The Medical Assistance for the Aged, Blind, and Disabled program serves seniors 65+ and disabled individuals not yet in nursing homes.

These limits remain significantly lower than expansion Medicaid:

The 60-Month Look-Back Period and Asset Rules

Nevada Medicaid’s asset transfer rules create a five-year financial microscope for long-term care applicants.

Understanding what counts as an asset—and which transfers trigger penalties—can mean the difference between immediate coverage and months of private-pay nursing home costs.

Countable vs. Exempt Assets

Medicaid distinguishes between resources you must spend down and those you can keep.

Countable assets include checking accounts, retirement funds (IRAs, 401ks), stocks, bonds, CDs, and cash.

However, several key exemptions allow families to preserve some wealth:

Primary Residence: Fully exempt if the applicant lives there or intends to return, provided equity doesn’t exceed $636,000 (unless a non-applicant spouse resides there, in which case it’s fully protected regardless of value).
Vehicle: One automobile of any value.
Personal Property: Household furnishings, clothing, and jewelry.
Funeral Planning: Irrevocable funeral trusts and burial plots.
Life Insurance: Face values up to $1,500.

How the Look-Back Penalty Works

When applying for Nursing Home Medicaid or HCBS Waivers, Nevada examines all financial transactions from the previous 60 months.

Any assets gifted or sold for less than fair market value trigger a penalty period of ineligibility.

The penalty calculation divides the transferred value by Nevada’s average private nursing home cost ($9,949.26 per month in 2026) to determine months of disqualification.

Critical Exception: MAABD (regular Medicaid for seniors/disabled) does not currently enforce a look-back period.

However, recipients who later need nursing home care will face scrutiny at that time, making early planning essential.

Safe Transfers That Avoid Penalties

Certain family transfers don’t trigger penalties, including transfers to spouses, disabled children of any age, or children under 21.

Additionally, adult children who lived in the parents’ home for at least two years providing care that delayed institutionalization, can receive the house penalty-free.

Siblings who are part-owners and reside there for one year also qualify for this exemption.

Major 2026 Change: Statewide Managed Care Expansion

January 1, 2026 marks the most significant transformation in Nevada Medicaid’s structure in decades.

The state is ending fee-for-service models in rural counties, requiring nearly all beneficiaries to enroll in private Managed Care Organizations (MCOs).

What’s Changing for Rural Residents?

Previously, Medicaid recipients in Clark and Washoe counties (Las Vegas and Reno areas) selected among five MCOs, while rural residents used fee-for-service cards accepted by any provider.

Now, all 17 Nevada counties operate under managed care, affecting approximately 75,000 rural beneficiaries.

Critical Deadline: Rural residents must select an MCO by December 26, 2025, or face automatic assignment. A 90-day grace period runs through March 31, 2026, allowing plan switches if the initial choice proves unsatisfactory.

Who Remains Exempt from Managed Care?

Several vulnerable populations stay in traditional fee-for-service Medicaid to ensure continuity with specialized providers:

• Seniors aged 65 and older
• SSI recipients (disabled individuals)
• Foster children and juvenile justice-involved youth
• HCBS Waiver recipients
• Children in the child welfare system

Available MCOs in 2026

Nevada contracts with five organizations. Rural residents choose between:

• CareSource (new nonprofit serving all counties)
• SilverSummit Healthplan (existing rural/urban coverage)

Urban residents may also access:

• Health Plan of Nevada (Clark County only)
• Anthem Blue Cross and Blue Shield
• Molina Healthcare of Nevada

How to Apply for Nevada Medicaid

Nevada offers multiple application pathways designed to accommodate different comfort levels with technology and urgent needs.

The process typically takes 45-90 days for standard applications, though pregnant women and emergencies may qualify for expedited processing.

Online Applications

The fastest method utilizes Access Nevada, the state’s benefits portal at accessnevada.dwss.nv.gov.

The system includes a pre-screening tool that identifies which programs fit your circumstances before you complete the full application.

Create an account to save progress and upload documents securely.

Phone and In-Person Options

Call 1-800-992-0900 (TTY: 1-800-326-6888) to request paper applications or schedule appointments at local Division of Welfare and Supportive Services offices.

In-person visits allow face-to-face assistance with complex situations, particularly helpful for seniors applying for long-term care or families with mixed immigration statuses.

Mail completed applications to: DSS, PO Box 15400, Las Vegas, NV 89114.

Required Documentation

Prepare these documents before applying to avoid delays:

• Government-issued photo ID and Social Security cards for all applicants
• Proof of citizenship or eligible immigration status (birth certificates, passports, permanent resident cards)
• 30 days of income verification (pay stubs, unemployment statements, Social Security award letters, pension documents)
• Current bank statements for all accounts
• Investment and retirement account statements
• Proof of Nevada residency (utility bills, lease agreements, driver’s license)
• Current health insurance cards (if any coverage exists)
• Pregnancy verification from healthcare provider (if applicable)

Retroactive Coverage Protection

Nevada Medicaid can cover medical bills from up to three months prior to your application date if you were eligible during that period.

This retroactive coverage often helps families facing unexpected hospitalizations or nursing home placements who delayed applying due to confusion about the process.

Special Eligibility Programs and Exceptions

Beyond standard categories, Nevada offers specialized pathways for specific circumstances that waive or modify traditional requirements.

Katie Beckett Eligibility for Disabled Children

Children under 19 with disabilities requiring institutional-level care can qualify for Medicaid regardless of parental income.

The Katie Beckett option allows disabled children to receive home-based care rather than entering institutions, with eligibility based solely on the child’s disability and care needs rather than family finances.

Former Foster Youth Automatic Coverage

Young adults under age 26 who were in Nevada foster care at age 18 and enrolled in Medicaid maintain eligibility regardless of current income.

This federal mandate ensures continuity of care during the critical transition to adulthood.

Breast and Cervical Cancer Treatment

Uninsured women under 65 diagnosed with breast or cervical cancer through the CDC screening program qualify for full Medicaid coverage during treatment.

Income limits apply, but this program eliminates the asset test usually required for similar-income adults.

Section 1619(B) Work Incentives

Disabled individuals who lose SSI cash benefits due to earnings can retain Medicaid coverage if their annual income stays below Nevada’s threshold of $47,006 (2026).

This program prevents the “cliff effect” where accepting a promotion or working more hours results in total healthcare loss.

Emergency Medicaid for Non-Citizens

Individuals who don’t qualify for regular Medicaid due to immigration status can receive Emergency Medicaid, covering labor and delivery costs plus treatment for life-threatening emergency conditions.

Coverage lasts only the duration of the emergency and requires month-by-month redetermination.

Practical Planning Strategies for 2026

Smart financial planning prevents common pitfalls that delay Medicaid approval or expose families to estate recovery claims.

Consider these actionable steps when preparing to apply.

Long-Term Care Planning Timeline

If nursing home care seems likely within five years, consult a certified Medicaid planning attorney immediately.

The 60-month look-back period means transfers made today won’t trigger penalties if you apply in 2031.

Waiting until care is imminent severely limits legal asset protection options.

Miller Trusts for Income Cap Exceptions

Applicants with income exceeding $2,982 monthly (nursing home) or $994 (MAABD) aren’t automatically disqualified.

Nevada permits Qualified Income Trusts (Miller Trusts) where excess income funnels into an irrevocable trust used only for medical expenses and personal care.

This legal mechanism allows high-income seniors to access Medicaid while preserving income for supplemental needs.

Estate Recovery Protection

Nevada Medicaid seeks repayment from beneficiaries’ estates after death, potentially forcing home sales that displace surviving families.

Protect the family home by ensuring proper titling, utilizing Lady Bird deeds, or transferring to exempt individuals (disabled children or caregiver children) before the look-back period begins.

Estate recovery cannot proceed if a surviving spouse, disabled child, or minor child resides in the home.

Spousal Protection for Married Couples

When one spouse requires nursing home care, the community spouse can keep the family home plus $157,920 in other assets (2026 limit).

Income from the institutionalized spouse can also transfer to the community spouse to maintain the household standard of living, ensuring the healthy spouse doesn’t face poverty.

Summary Chart: 2026 Key Updates

Official Sources and References

For application assistance and official verification of these requirements, consult these primary government sources:

Nevada Division of Health Care Financing and Policy (DHCFP) – The state agency administering Medicaid benefits, provider enrollment, and policy updates.

Nevada Access Portal – Official online application system for Medicaid, SNAP, and TANF benefits with pre-screening tools.

Additional Resources:

• Nevada Department of Welfare and Supportive Services (DWSS): 1-800-992-0900
• Social Security Administration (2026 Federal Benefit Rates)
• Medicaid.gov (Federal eligibility guidelines and CHIP parameters)

Disclaimer: This information reflects Nevada Medicaid policies as of January 2026. Income limits and regulations change periodically. Consult a qualified elder law attorney for complex asset protection strategies or a DWSS representative for definitive eligibility determinations regarding your specific situation.