Medicaid for nursing home and home care in Illinois

Who qualifies

You need to meet a care test and money tests.

• Care need: a screening called the Determination of Need (DON) must show you are at risk of needing a nursing home.
• Age or disability: 65 or older, blind or disabled for AABD Medical. The Community Care Program is for people 60 or older.
• Residence and status: you live in Illinois and are a U.S. citizen or an eligible non-citizen.
• Assets and income: see the table below.

Income over the standard? You can still qualify. For a nursing home resident, IDHS's income standard is the personal needs allowance. Your income above that, minus any allowance for a spouse or family member at home, goes toward your care, and Medicaid pays the rest.

What counts and what does not

Assets that do not count:

• Your home, while you live in it. If you move to a nursing home or supportive living, it stays exempt if you say you plan to return. It also stays exempt if your spouse, a child under 21, a blind or disabled child, a dependent sibling, or a child who cared for you and lived there for the two years before you moved still lives there.
• For the Community Care Program: your home, car and personal furnishings.

Home equity. If your equity in your home is more than $752,000, Medicaid will not pay for nursing home, supportive living or Department on Aging waiver care. This does not apply if your spouse, a child under 21, a blind or disabled child, a dependent sibling, or a caregiver child lives there. You can also ask for a hardship waiver. IDHS values a home at the latest tax assessment times 10 in Cook County, or times 3 in other counties. You can give IDHS a different value from a licensed real estate professional.

Income disregard. IDHS does not count the first $25 of your monthly income (other than SSI).

Gifts and transfers. IDHS looks back 60 months (5 years) from the date you ask the state to pay for long-term care. Giving away assets or income for less than they are worth can cause a penalty period, when Medicaid will not pay for your care. This rule applies to nursing homes, supportive living and Department on Aging waiver services.

If your spouse stays at home

Illinois protects money for the spouse who still lives at home. These amounts went up on January 1, 2026.

• Assets: the spouse at home can keep up to $143,172. IDHS figures this amount only once, when you first apply.
• Income: you can give your spouse enough of your income to bring their own income up to $4,066.50 a month. If your spouse's own gross income is already that high, they get no allowance.

What Medicaid pays for

Nursing home care

Medicaid pays the nursing home for the part of the bill your income does not cover.

Supportive living

Medicaid can also help if you live in a Supportive Living Program (SLP) setting. You pay room and board from your income, at the SSI rate (half of it each if a couple shares a room), and keep a personal allowance of $120 a month.

Care at home: Community Care Program

The Department on Aging's Community Care Program (CCP) helps people 60 and over who might otherwise need a nursing home stay at home. The program includes Illinois's Persons Who are Elderly Waiver. Services include:

• In-home service: help with household tasks and personal care
• Adult day service: daytime care, which also gives family caregivers a break
• Emergency home response: a 24-hour emergency call button
• Automated medication dispenser: a machine that gives out pills on schedule
• Care coordination

You must apply for Medicaid and enroll if you qualify.

How to apply

1. For home care, call the Senior HelpLine at 1-800-252-8966 (711 TRS). You will be sent to your local Care Coordination Unit, which does the Determination of Need. You can also find your unit with the Department on Aging's online map.
2. Apply for Medicaid (AABD Medical) online at abe.illinois.gov, at your local IDHS office, or by calling the IDHS Help Line at 1-800-843-6154 (TTY 1-866-324-5553).
3. Keep records of gifts, sales and other transfers from the last 60 months. IDHS verifies transfers made in that period.
4. Watch your mail for requests for more papers and for the decision notice.

After you apply

• Reviews: IDHS reviews long-term care cases again over time. Answer every renewal letter by its due date.
• Report changes in income, assets or where you live to IDHS.
• Appeals: You have 60 days from the date on the notice to appeal a Medicaid decision. File online through ABE or Manage My Case; by email to [email protected]; by fax to 312-793-3387; by mail to IDHS Bureau of Hearings, 69 W. Washington, 4th Floor, Chicago, IL 60602; at your local IDHS office; or by phone at 1-800-435-0774 (TTY 1-877-734-7429). To keep benefits during the appeal, file on or before the date they would stop.

Things people miss

• The asset limit is much higher than the SSI limit. Illinois allows $17,500 for AABD Medical, not the SSI amount of $2,000.
• Your home is safe if you plan to return. Say so on the application.
• Estate recovery. After death, HFS may seek repayment from the estate for AABD help, including long-term care. It does not recover while a spouse is alive, or if there is a child under 21 or a blind or disabled child. For deaths on or after July 1, 2022, the first $25,000 of an estate is protected. Heirs can ask for an undue hardship waiver.

Free help

• Senior HelpLine (Illinois Department on Aging): 1-800-252-8966 (711 TRS), for the Community Care Program and Medicare counseling (SHIP).
• IDHS Help Line: 1-800-843-6154 (TTY 1-866-324-5553), for Medicaid applications.

For other programs, see all benefits in Illinois. For a family guide to costs, see paying for a nursing home.

Phone numbers: Free help lines for Illinois agencies

Check what you may qualify for