Medicaid Asset Limit Nevada 2026: Exempt Assets, Spend-Down, and Level of Care Assessment

The 2026 Asset Limit for Long-Term Care Medicaid

Nevada Medicaid long-term care eligibility requires meeting both income and asset tests. The asset limit for a single applicant is $2,000 in countable resources. For married couples where one spouse needs care and the other remains in the community, the community spouse can retain between $32,532 (minimum) and $162,660 (maximum) under the Community Spouse Resource Allowance (CSRA).

These numbers are harsh. A lifetime of savings must be nearly exhausted before the state will help pay for nursing home care or home-based services through the Frail Elderly waiver. Understanding what counts — and what does not — determines whether the application gets approved or denied.

What Counts as a Countable Asset

DWSS (Division of Welfare and Supportive Services) evaluates every asset the applicant owns on the date of application. Countable resources include:

• Bank accounts (checking, savings, money market)
• Certificates of deposit
• Stocks, bonds, and mutual funds at current market value
• Cash value of life insurance policies with a combined face value exceeding $1,500
• Additional real property beyond the primary residence
• Vehicles beyond the primary vehicle (one vehicle is exempt regardless of value)
• Retirement accounts (IRAs, 401(k)s) that are not in payout status

DWSS will request 60 months of bank statements and financial records as part of the look-back review. Every transfer, withdrawal, and asset disposition during that period is scrutinized.

Exempt Assets

Certain assets are excluded from the $2,000 countable resource calculation:

Primary residence. The home where the applicant lives (or intends to return to) is exempt, provided the equity value does not exceed the state cap. The applicant or their spouse must occupy the home, or the applicant must express intent to return. However, the home is not protected from Medicaid estate recovery after the applicant's death — MERP can place a lien against the property.

One vehicle. Regardless of value, the applicant's primary vehicle is exempt.

Personal belongings and household goods. Furniture, clothing, and everyday items are exempt.

Prepaid burial arrangements. An irrevocable prepaid funeral plan and a burial plot are exempt. This is one of the most common spend-down strategies: purchasing an irrevocable burial plan converts countable cash into an exempt asset.

Term life insurance. Policies with no cash surrender value are exempt regardless of face value. Whole life policies with a combined face value of $1,500 or less are also exempt.

The ADSD Level of Care Assessment

Meeting the financial limits gets your foot in the door. The clinical gate is the ADSD (Aging and Disability Services Division) Level of Care assessment, which determines whether the applicant meets the Nursing Facility Level of Care (NFLOC) standard required for the Frail Elderly waiver and institutional Medicaid.

The assessment evaluates functional deficits across activities of daily living:

• Bathing — ability to wash independently
• Dressing — ability to put on and remove clothing
• Toileting — ability to use the toilet independently
• Transferring — ability to move between bed, chair, and standing position
• Eating — ability to feed oneself
• Continence management — ability to manage bladder and bowel function

The applicant must demonstrate deficits in at least three functional areas to meet the NFLOC standard. The assessment is conducted by an ADSD assessor or through a Nevada Care Connection Aging and Disability Resource Center (ADRC), either in person at the applicant's residence or care facility.

Cognitive impairment from dementia can satisfy functional deficit criteria even when the applicant is physically capable. A person who can physically dress themselves but lacks the cognitive ability to select appropriate clothing or initiate the dressing process has a functional deficit.

Spend-Down Strategies

When assets exceed $2,000, families must reduce countable resources to qualify. Legitimate spend-down options include:

Pay off debts. Mortgage payments, credit card balances, medical bills, and tax obligations reduce countable assets while satisfying legitimate obligations.

Home repairs and modifications. Accessibility improvements (wheelchair ramps, grab bars, walk-in showers) improve the applicant's quality of life and reduce countable cash.

Prepaid burial. An irrevocable funeral plan converts countable cash into an exempt asset. Plans can be purchased at reasonable cost without triggering look-back penalties.

Vehicle purchase or repair. If the applicant's current vehicle is unreliable, replacing or repairing it is a legitimate expenditure. The replacement vehicle becomes the exempt primary vehicle.

Pay for care directly. Paying privately for home care, assisted living, or medical expenses at fair-market rates is a legitimate spend-down when the expense is for the applicant's care. Keep receipts and verify the treatment with DWSS or a qualified Medicaid adviser before relying on it.

What does not work: giving assets away to family members. An uncompensated transfer — a transfer for less than fair market value — creates a penalty period during the 60-month look-back period, subject to statutory exceptions. During that period, the applicant is ineligible for Medicaid coverage of long-term care costs. The penalty period length is calculated by dividing the transferred amount by the average private-pay nursing home cost.

The Income Side

Even if assets are under $2,000, monthly income must also fall below $2,982 (300% of the Federal Benefit Rate) for the Frail Elderly waiver. If income exceeds this cap, a Miller Trust (Qualified Income Trust) can redirect the excess income to make the applicant eligible.

Establishing and managing a Miller Trust requires a financial POA with explicit trust-creation authority in the special instructions section. The Nevada Power of Attorney & Guardianship Kit includes the statutory POA form with pre-formatted Miller Trust authorization language, the DWSS authorized representative walkthrough, and the Medicaid eligibility worksheet for calculating both the asset and income tests against current 2026 thresholds.

See more Nevada guides →