Here's what surprises families most: you can have $130,000 in the bank, own an $800,000 home, drive a brand-new car, and still qualify for Medi-Cal to pay for nursing home care.

It's not about spending all your life savings. It's about understanding what counts and what doesn't, and planning strategically.

Medi-Cal looks at three specific things when determining qualification for nursing home coverage. Let's walk through each one and see where you might stand.

Note: This guide is specifically about Medi-Cal long-term care coverage, not general Medi-Cal health insurance. Medi-Cal is California's Medicaid program. If you're reading this from another state, the same basic principles apply, though specific numbers and rules vary by state.

Part 1: Do You Need Nursing Home-Level Care?

Before Medi-Cal looks at your finances, they assess your health needs. You typically need to meet what's called "Nursing Facility Level of Care"—a doctor certifies that you require professional nursing or significant help with daily activities.

What generally qualifies:

• Needing help with 2 or more Activities of Daily Living (ADLs): bathing, dressing, using the bathroom, moving from bed to chair, or eating

• Requiring skilled nursing care (wound care, IV medications, etc.)

• Having cognitive impairment that requires supervision for safety

What usually doesn't qualify on its own:

• Just being elderly or living alone

• Needing some help but managing most daily activities independently

• Qualifying for assisted living but not requiring skilled nursing

Example Scenario: Margaret's Situation

Margaret is 78 and has moderate dementia. She can still dress herself and eat independently, but she's fallen twice in the past month and sometimes forgets to take her medications. Her daughter worries she's not safe alone.

Would she likely qualify? Possibly. If Margaret needs help with bathing and transferring (getting in/out of bed or chairs safely) due to fall risk, plus supervision for medication management, she might meet the nursing facility level of care. A doctor would need to evaluate and certify this.

The key: you're not just "old" or "forgetful"—you typically need documented care needs that require a nursing facility setting.

Part 2: Do Your Assets Fall Under the Limit?

This is where most families focus, and it's what changed significantly in January 2026. (Read more about the 2026 Medi-Cal changes and how they affect qualification.)

The limits as of 2026:

• Individual: $130,000 in countable assets

• Married couple (one needs care): The person needing care can have $130,000, and the spouse staying home can typically keep approximately $157,920

• Married couple (both need care): $195,000 combined

What Counts as an Asset?

Countable (counts toward your limit):

• Bank accounts and cash

• Stocks, bonds, mutual funds

• Second vehicles

• Investment properties or rental real estate

• Retirement accounts not actively paying out income

Exempt (doesn't count):

• Your primary home (if you, your spouse, or dependent child lives there)

• One car, regardless of value

• Personal belongings—furniture, jewelry, clothing

• Burial plots and irrevocable funeral trusts

• Life insurance with face value under $1,500

Example Scenario: The Chens' Dilemma

Robert Chen needs nursing home care. He and his wife Linda have $180,000 in savings, own their home (worth $600,000), and have one car.

Would they qualify? Not yet. Here's why:

• The home doesn't count (exempt)

• The car doesn't count (exempt)

• But they have $180,000 in savings, which is $50,000 over Robert's limit

What families in this situation often do: Work with an elder law attorney to convert that extra $50,000 into exempt assets—things like home repairs, a newer reliable vehicle, prepaying funeral costs, or paying off debts. This approach can bring their countable assets under $130,000.

Many families don't realize this type of strategic planning is possible rather than just "spending it down" randomly.

Part 3: Your Income Determines What You Pay

Here's something that surprises people: there's typically no income limit to qualify for Medi-Cal nursing home coverage. You can have a $5,000 monthly pension and still potentially qualify.

However, your income determines your "Share of Cost"—what you contribute toward the nursing home bill each month.

How it generally works:

Take your total monthly income (Social Security, pensions, etc.), subtract $35 (your "Personal Needs Allowance" for 2026), and the rest typically goes to the nursing home as your share of cost. Medi-Cal pays the remaining balance.

Example:

• You receive $2,400/month in Social Security

• You keep $35 for personal needs

• You pay $2,365 to the nursing home

• If the nursing home costs $15,000/month, Medi-Cal would pay the remaining $12,635

Example Scenario: James's Income Question

James receives $3,200/month from Social Security and a pension. His family worries this is "too much" to qualify.

Would he likely qualify? Yes, income-wise. There's typically no upper limit. He would keep $35/month and contribute $3,165 toward his care. If the nursing home bill is higher, Medi-Cal would cover the difference.

The key insight: higher income doesn't disqualify you—it just means you contribute more toward your care costs.