What Is Medicaid?

Medicaid is a health coverage program for people with limited income and assets, paid for jointly by the federal government and the states and run by each state individually. For families dealing with aging parents, one part matters above all the rest: Medicaid is the main way long-term nursing-home care gets paid for in this country.

It's easy to confuse with Medicare, which is a different program with a similar name. If that's your question, go to Medicaid vs Medicare.

Who runs Medicaid?

Both the federal government and your state. Washington sets minimum rules and pays a share of the cost. Your state runs the program day to day, decides many of the eligibility details, and is who you actually apply to.

That's why advice you read online so often doesn't match your experience. Income limits, asset limits, program names and application processes genuinely differ from one state to the next. Your state's rules are the ones that count.

Who qualifies?

Medicaid covers several distinct groups, and the rules for each are different. The main ones are children and families on low incomes, pregnant women, people with disabilities, adults covered under the Affordable Care Act expansion, and older adults who need long-term care.

That last group is what this site is about. Qualifying for long-term care Medicaid means passing a medical test showing you need that level of care, and a financial test covering income and assets. See who qualifies for Medicaid long-term care.

What does Medicaid pay for?

For people qualifying on the basis of age or disability, coverage typically includes doctor visits, hospital care, prescriptions, lab work and medical equipment, plus the services that no other program covers:

• Nursing-home care. The full cost of a shared room and the care that goes with it, indefinitely, with no benefit cap.
• Care at home. Through waiver programs that pay for personal care, adult day programs and respite for family caregivers.
• Help with Medicare costs. For people on both programs, Medicaid often covers Medicare premiums and copayments.

Why does it matter so much for long-term care?

Because nothing else pays for it. Medicare covers only a short skilled-nursing stay after a hospital admission. Regular health insurance doesn't cover custodial care at all. Long-term care insurance pays only if someone bought a policy years earlier.

At a national median of around $9,581 a month for a shared nursing-home room, paying privately for a multi-year stay is beyond most families. Medicaid is what's left, which is why so many middle-class families end up learning its rules.

Cost figure is a national median from the CareScout Cost of Care Survey, data collected July to November 2025. Last verified July 30, 2026.

Your state may not call it Medicaid

Many states brand the program under their own name, which makes searching confusing. California calls it Medi-Cal. Massachusetts calls it MassHealth. Tennessee uses TennCare, Washington uses Apple Health, and Oklahoma uses SoonerCare.

It's the same underlying program in each case. When you call, using the local name gets you to the right place faster.

Common questions

Is Medicaid the same as Medicare?

No. Medicare is federal health insurance based on age or disability, with income playing no part. Medicaid is a joint federal and state program based on financial need, and it's the one that pays for long-term nursing-home care.

Do you have to be poor to get Medicaid?

You need limited countable income and assets, which isn't quite the same. Because the home, one car and personal belongings usually don't count, middle-class families qualify for long-term care coverage more often than they expect.

Does Medicaid cover care at home instead?

In most states, yes, through home and community-based waiver programs. Those are capped rather than guaranteed, so waiting lists are common, and they don't pay rent or a mortgage.

How do I apply?

Through your state Medicaid agency, online, by phone or in person. Expect to document income, assets and several years of financial records. Apply as soon as care begins, because the application date affects which bills can be covered.

Sources

• CareScout, "Cost of Care Survey," data collected July through November 2025, for the nursing home cost figure.
• Centers for Medicare and Medicaid Services, "2026 SSI, Spousal Impoverishment, and Medicare Savings Program Resource Standards," CMCS Informational Bulletin, December 9, 2025.

Written and reviewed by Owen Hastings. Last reviewed July 30, 2026. Read our editorial policy for how we source and check these figures.