Medicaid for nursing home and home care in Alaska

Who qualifies

Two state offices share the work:

• The Division of Public Assistance (DPA) checks your income and assets through an application and an interview.
• Senior and Disabilities Services (SDS) checks whether you need nursing home level care.

You must meet both tests. People 65 and over are looked at under Alaska's Medicaid rules for older and disabled adults, not the income-only rules used for younger adults.

The money test

Medicaid also has an asset limit. Many of your belongings do not count. Ask DPA for the current asset limit and what is not counted before you decide not to apply.

If your income is over the standard, do not give up. Ask DPA what options you have before you decide.

The care test

SDS nurses or other trained staff do a functional assessment in person or by video call. It looks at how much help you need with daily life. A nurse supervisor reviews the results. You get a copy of the results and the decision about your level of care.

If your spouse stays at home

Alaska uses federal spousal protection rules so the husband or wife at home is not left without money.

• Savings. Your spouse can keep up to $162,660 of the couple's countable resources in 2026.
• Income. Alaska's monthly income maintenance standard for a spouse at home is $4,066.50. If your spouse's own income is lower, part of your income can be set aside for them.
• Other family members. For each other family member who depends on you, the standard is $1,355.50 a month.

What you pay toward your care

After you qualify, Medicaid looks at your income again to see how much you pay toward your care each month.

• In a nursing home, you keep $200 a month for personal needs. Amounts for a spouse or family at home can also be set aside. Most of the rest goes to the nursing home.
• At home on the ALI waiver, you keep $1,656 a month, or $1,396 if you live in a licensed assisted living home. Because these amounts are high, many people at home pay little or nothing toward their waiver services.

Care at home: the ALI waiver and other programs

Alaskans Living Independently (ALI) waiver

• For: adults 21 and over who need nursing home level care, including people 65 and over and adults with physical disabilities.
• What it pays for: person-centered home and community services and supports, set out in a care plan. You can get waiver services at home or in a licensed assisted living home. Ask SDS or your ADRC for the full list of services.
• Your choice: if you meet nursing home level of care, you can choose home and community services instead of a nursing home.
• Waitlist: The state says there is no waitlist for this waiver.

The current ALI waiver took effect July 1, 2026. During public comment, most people asked for a higher personal needs allowance. The state said that would need a rule change and is looking at it for the future.

Other Medicaid help at home

• Community First Choice (CFC): for people who meet the financial and medical rules for institutional care. It can pay for personal care, a personal emergency response system, case management and chore services, and you can direct your own care. Start by calling your local ADRC; the application is form CFC-06.
• Personal Care Services (PCS): help with bathing, dressing and eating, plus shopping, laundry and light housework, through an agency or with an assistant you choose and supervise. The application is form PCA-08.

How to apply

1. Start with a pre-screening (optional). Your Aging and Disability Resource Center (ADRC) can check whether you are likely to qualify before you fill out an application. Call 1-855-565-2017. DPA also has an online Medicaid Eligibility Pre-Screening Tool.
2. Apply for Medicaid with DPA. Apply online through the Alaska Connect portal at alaskaconnect.ilinx.com/engage/dpa, or call the DPA Virtual Contact Center at 800-478-7778 (TDD/Alaska Relay 7-1-1).
3. Do the DPA interview. DPA decides financial eligibility through the application and an interview.
4. Apply for the waiver or CFC with SDS. The SDS Central Application Processing Unit handles applications for ALI, CFC and PCS. Its mailing addresses are 3601 C Street, Suite 902, Anchorage, AK 99503, and 350 Main Street, Suite 404, Juneau, AK 99811. Call SDS at 907-269-3666 or email [email protected] with questions.
5. Have the functional assessment. SDS sets it up and sends you the results.

After you apply

• Report changes in income, assets, address or living situation to DPA through Alaska Connect, at 800-478-7778, or at a Public Assistance office.
• Renewals. DPA reviews Medicaid eligibility again, and SDS reviews waiver and CFC eligibility through a renewal application.
• If you are denied, read your notice for how to appeal and the deadline, and act quickly.
• Coming in 2027: Alaska is making changes to Medicaid starting January 2027. Check the Apply for Medicaid page on health.alaska.gov for updates.

Free help

• Aging and Disability Resource Centers: 1-855-565-2017 statewide. Anchorage: 907-343-7770. Mat-Su: 907-373-3632. Fairbanks area: 907-452-2551. Southeast: 800-478-7245. Kenai Peninsula, Kodiak and Valdez-Cordova: 907-262-6333 or 800-770-7911. Western Alaska: 1-800-478-4139.
• Senior and Disabilities Services: 907-269-3666.
• Medicare Information Office (Alaska's SHIP): 1-800-478-6065, for Medicare questions.

Read more about paying for a nursing home and Medicare, or see all benefits in Alaska.

Phone numbers: Free help lines for Alaska agencies

Check what you may qualify for