When Medicaid in Nevada Will Pay for Long-Term Care in a Nursing Home, Assisted Living, and Home Care

With the average monthly cost of a private room in a nursing home in Nevada exceeding $12,000 in 2024, people who anticipate needing long-term care will want to focus on making sure they have a way of paying for that care. Nursing home care is usually paid for by private funds, nursing home insurance (long-term care insurance), or Medicaid.

If you can't afford to pay with your own funds, and you don't have long-term care (LTC) insurance, Nevada's Medicaid program might pay for your care.

Medicaid is a medical assistance program funded by the federal and state governments to pay for long-term care for people who meet certain requirements, such as being over 65, disabled, or blind. Other types of Medicaid services have eligibility guidelines that are different from the rules for long-term care Medicaid.

The state also offers some limited services for people who still live at home but would otherwise require a nursing home. These are called home and community-based service (HCBS) waiver programs. Similar income and asset rules apply to these programs.

How Nevada Medicaid Assesses the Necessity of a Nursing Home

If you live in a skilled nursing facility, intermediate care facility, or hospital for 30 days or more, Medicaid automatically considers you to need a nursing home level of care. With this level of need, you can qualify for Medicaid long-term care benefits if you also meet Nevada's income and resource requirements.

If you haven't yet entered a facility, Nevada's Medicaid program will use a Pre-Admission Screening Resident Review (PASRR) test to determine whether you need a nursing home. The program will also use a Level of Care (LOC) Assessment Form (Form FA-19) to determine the level of care you need. Nursing home staff usually does this screening, which includes a review of the person's medical diagnoses and abilities.

The LOC form asks about the level of assistance you need with various activities of daily living (ADLs), such as:

• moving about
• getting dressed
• eating
• personal hygiene, and
• using the bathroom.

It also asks whether you have any special needs, such as the need for durable medical equipment, like a hospital bed or wheelchair.

In general, you must require a level of care that can't be met anywhere but in a nursing home. Nevada Division of Welfare and Supportive Services (DWSS) makes the final decision on eligibility for institutional Medicaid.

Typically, your care facility can help you with the Medicaid application process, or you can apply directly with the DWSS online through Access Nevada or by calling your local DWSS office. Before you apply, make sure that you meet the eligibility criteria.

Medicaid Income Rules in Nevada

In Nevada, you can qualify for Medicaid-paid long-term care with a monthly income up to $2,901 in 2025, or 300% of the SSI payment level. Your spouse's income doesn't affect your eligibility unless your spouse is also applying for Medicaid LTC benefits. The income limit for a married couple with both spouses applying for Medicaid long-term care is $5,802 per month (in 2025).

Nevada's LTC Medicaid income limits are higher than those for other Medicaid health care benefits. And spousal income counts toward eligibility for regular Medicaid in Nevada.

If you have income over the monthly amount and need a nursing home, Nevada allows you to establish a Qualified Income Trust to meet the Medicaid income limits. A Qualified Income Trust is a special account used only for Medicaid purposes. You set up your income to go into a Qualified Income Trust, and it's then used to pay a portion of the cost of the nursing home.

The trust can also pay for Medicare premiums and premiums for supplemental health plans. If you're single and live in a nursing facility, you can take only a $154 per month as a personal needs allowance from the trust. The rest goes to your nursing home costs and allowable medical expenses (like Medicare premiums).

Medicaid Asset Rules in Nevada for Long-Term Care

Medicaid for long-term care has different resource rules than other Medicaid programs. Resources are assets like:

• real property (real estate)
• personal property
• life insurance with a cash value
• vehicles
• motorhomes
• boats
• IRAs and 401Ks
• bank accounts, and
• cash on hand.

You'll need to add up the values of all of these to determine how much you have in resources.

If you're single, you can only have up to $2,000 in resources with a few allowable exclusions, such as a car and your home (with equity up to $730,000 in 2025). If you're married, your spouse at home (community spouse) can keep up to $157,920 of joint assets (in 2025). But if both spouses are applying for LTC Medicaid, the combined asset limit is just $3,000.

(Even if your home is exempt for LTC Medicaid eligibility purposes, it might still be subject to estate recovery in Nevada.)

Medicaid-Paid Assisted Living or Home Health Care in Nevada

Medicaid "waivers" will pay for some services to individuals who can appropriately be cared for at home or in an adult group care facility. These waivers can help individuals maintain their independence, sometimes in their own homes, as an alternative to nursing home placement.

The same financial eligibility rules that apply to Medicaid coverage for nursing homes apply to HCBS waiver programs. Thus, in 2025, an individual applicant can't have a monthly income greater than $2,901.

Assets are limited to $2,000 for an individual and $3,000 for a couple with both spouses applying. Non-applicant spouses can keep up to $157,920 in 2025, just as they can with nursing home Medicaid.

Nevada's Home and Community-Based Waiver for the Frail Elderly (FE Waiver)

The home and community-based service waiver for the Frail Elderly (FE Waiver) of Nevada's Department of Health and Human Services (DHHS) Aging and Disability Services Division (ADSD) provides non-medical services to older adults to help them maintain independence in their own homes instead of going into a nursing home. Applicants for the FE Waiver must:

• be at least 65 years old
• require a nursing home level of care (or would require a nursing home within 30 days if the waiver services weren't available)
• have a continued need for services, and
• meet Medicaid's LTC income and asset limits.

Note that the FE Waiver program provides only non-medical services, so this HCBS program doesn't cover nursing care.

A licensed social worker will determine what services you need and then coordinate and oversee the needed services. Some services provided under this waiver program include:

• help with personal care, such as bathing, transferring (like moving from your bed to a chair), and eating
• help with homemaker tasks like meal preparation, house cleaning, laundry, and shopping
• some services for adult daycare (not medical daycare)
• an adult companion, and
• a personal emergency response system (for reporting falls).

The FE Waiver also provides for augmented personal care in residential facilities for groups or assisted living settings.

There are limited slots available for this waiver program. The ADSD uses a waitlist to prioritize applicants. When funding becomes available, the division processes applications based on three criteria:

• the level of care needed
• the risk factors for individuals, and
• the date of the waiver application.

Nevada's FE Waiver program allows your family members to serve as paid caregivers, including your spouse. Contact ADSD for more details.

Nevada's HCBS Waiver for Persons with Physical Disabilities (PD Waiver)

The Nevada home and community-based service waiver for Persons with Physical Disabilities (PD Waiver) serves Nevadans of all ages who have a documented physical disability and who require a nursing home level of care.

This program offers services similar to those the FE Waiver program offers, along with accessibility adaptations for your home and specialized medical equipment and supplies. To qualify for PD Waiver services, you must meet the applicable functional and financial requirements.

Nevada's Structured Family Caregiver Waiver (SFCG Waiver)

In January 2025, Nevada's new Structured Family Caregiver Waiver (SFCG Waiver) began paying family caregivers to provide in-home services for Medicaid long-term care recipients diagnosed with dementia. SFCG Waiver services include:

• case management
• personal care services
• respite services
• homemaker services, and
• home health aide services.

To qualify for SFCG Waiver services, you must have a dementia diagnosis and need a nursing facility level of care. You must also meet Medicaid's long-term care financial eligibility requirements. But because this is a Medicaid waiver service, participation is limited, and you might encounter a waiting list.

You can choose anyone you like to serve as your paid caregiver, including any family member. But your caregiver must live in your home (or you live in theirs) and must enroll with a provider agency.

To learn more, contact your local ADSD office or call the ADSD at 702-486-6930 (in Las Vegas or Clark County) or 888-729-0571 (in all other areas).

Personal Care Services for the Elderly or Disabled in Nevada

Medicaid's Personal Care Services (PCS) program provides services to Nevadans who, due to a chronic health issue or disability, need assistance to avoid moving into a nursing home. The PCS program provides assistance with activities of daily living and instrumental activities of daily living to support and maintain individuals who live at home but need help with things like:

• bathing
• dressing
• toileting
• eating
• mobility and ambulation
• light housekeeping, and
• other personal care activities as authorized by the program.

Because the PCS program is an entitlement under Medicaid, everyone who meets the eligibility criteria can get these services. To learn more about the PCS program and eligibility requirements, contact the Nevada DHHS Division of Health Care Financing and Policy (DHCFP).

For general information about long-term services and support (LTSS) under Nevada Medicaid, visit the DHCFP's LTSS page.