Minnesota Medicaid for Seniors & Long-Term Care
Updated August 2026
Seniors age 65 and older who need long-term care face different eligibility rules than working-age adults. The income limit for long-term care MA in Minnesota is 300% of the Social Security Federal Benefit Rate — the same threshold used in most states. As of 2026, this equals $2,982 per month for an individual ($994 × 3).
$3,000
Individual asset limit
$2,982/mo
Income limit (300% FBR, 2026)
Elderly Waiver (EW)
Largest HCBS waiver for seniors
Minnesota's Alternative Care program bridges seniors who don't yet meet Medicaid's financial limits
The Alternative Care (AC) program is Minnesota-specific: it provides home and community-based services to people age 65 and older who do not yet meet the financial eligibility requirements for Medical Assistance long-term care but are at risk of nursing facility placement. Few states have an equivalent program. Contact your county office to ask about AC if your income or assets exceed standard MA limits.
Medical Assistance for seniors: income and asset rules
The asset limit for a single individual is $3,000 ($6,000 for a household of two). A couple where one spouse enters a nursing facility may retain the community spouse resource allowance (CSRA): per Minnesota DHS's Eligibility Policy Manual, Minnesota sets no minimum CSRA and allows the community spouse to keep up to the federal maximum of $162,660 of the couple's combined non-exempt assets (2026). Minnesota also allows a community spouse minimum monthly maintenance needs allowance (MMMNA) to ensure the spouse at home retains adequate income. Assets that are generally excluded include the primary home, one vehicle, personal belongings, prepaid funeral arrangements, and certain other assets.
The Elderly Waiver (EW): home care instead of a nursing facility
The Elderly Waiver is Minnesota's largest HCBS waiver for adults age 65 and older. It allows people who meet nursing facility level of care to receive services at home or in an assisted living facility instead — at a cost to Medicaid generally lower than nursing facility placement.
- Personal care assistance (PCA)
- Home health aide and skilled nursing visits
- Adult day services
- Adult foster care and family adult foster care
- Assisted living and residential care home services
- Homemaker and chore services
- Respite care for family caregivers
- Case management and care coordination
- Environmental modifications and assistive technology
The program operates through county social services and Lead Agencies who coordinate care. Enrollment is not capped, but you must meet the nursing facility level of care standard and the MA financial criteria.
Alternative Care and Consumer Directed Community Supports
The Alternative Care (AC) program is funded entirely by the state — no federal Medicaid match. It covers people age 65 and older who meet nursing facility level of care but whose income or assets currently exceed the MA long-term care limits, providing many of the same services as the Elderly Waiver while the person spends down assets to MA eligibility levels. Participants pay a monthly premium based on income and assets; once resources fall to the MA asset limit, they transition from AC to the Elderly Waiver.
Minnesota's Consumer Directed Community Supports (CDCS) program lets MA members with disabilities and some elderly members design their own care plan and hire their own workers — including family members in some cases — rather than receiving services through a provider agency. CDCS is available to members enrolled in several HCBS waiver programs, including the Elderly Waiver, and gives members a monthly budget based on assessed needs; a financial management services (FMS) organization assists with payroll, taxes, and purchasing.
Nursing facility coverage
Medical Assistance covers nursing facility care for eligible members. Minnesota has many nursing facilities that accept MA, though some facilities may have limited MA-funded beds. Your county social services office can help identify MA-certified facilities in your area.
Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance, which is $132/month in Minnesota. If income exceeds the institutional Medicaid limit, Minnesota may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible.
Estate recovery
Minnesota operates an estate recovery program through DHS. The state may seek reimbursement from the estate of an MA member who received long-term care services — nursing facility or HCBS — after age 55. Recovery is also possible for members of any age who received institutional long-term care. Estate recovery does not apply to MA medical coverage received before age 55 outside of long-term care settings.
What long-term care Medicaid typically covers
Long-term care Medical Assistance covers a range of institutional and home-based services for eligible seniors and adults with disabilities.
- Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
- Physical, occupational, and speech therapy provided in a nursing home
- Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
- Home health aide visits for those receiving care at home
- Adult day health care programs
- Respite care to give family caregivers temporary relief
- Durable medical equipment prescribed by a physician
- Transportation to and from medical appointments
Medical Assistance (Minnesota Medicaid)
- Medical Assistance (Minnesota Medicaid): mn.gov/dhs/people-we-serve/children-and-families/health-care/medical-assistance
Related guides
Medicaid for Seniors
How Medicaid pays for nursing home and long-term care for older adults.
Read more →Estate Recovery
When states can seek reimbursement from an enrollee's estate after death.
Read more →Medicaid & Social Security
How Social Security benefits and Medicaid eligibility interact.
Read more →