Medicaid Spend-Down in Illinois

Illinois sets its own income standard for nursing home Medicaid rather than using the federal figure most states default to, and its asset limit is notably higher than the $2,000 baseline — both details that can catch families off guard if they've researched Medicaid rules in another state first.

Income limit

Illinois's own income limit for a single Nursing Home Medicaid applicant is $1,330/month (effective April 2026 through March 2027) — lower than the $2,982/month figure used in most income-cap states. For married applicants both applying, the combined limit is $1,803/month. Because Illinois sets its own standard and updates it annually rather than using the common federal figure, it's worth confirming the current number directly rather than assuming it matches a neighboring state. Nursing home residents keep a $60/month personal needs allowance.

Asset limit

The asset limit for a single applicant is $17,500 — well above the federal baseline. For married applicants where both spouses are applying, the combined limit is also $17,500.

Community Spouse Resource Allowance

When only one spouse applies, the applicant's asset limit stays at $17,500, and the non-applicant community spouse can typically retain up to $143,172 (2026) — a figure Illinois sets somewhat lower than the $162,660 maximum used in most other states.

What to do if your parent is over the limit

If assets are over $17,500, asset spend-down applies the same way it does elsewhere — see countable vs. exempt assets for what counts. If income is over $1,330/month, ask an Illinois elder law attorney whether a Qualified Income Trust applies in your parent's situation, since Illinois's lower income standard makes this more likely to come up than in states using the $2,982 figure. Our spend-down calculator can give a rough starting estimate using Illinois's current asset limit.