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How income is treated: all states
Every state and DC, with how sure we are of each. Research summary, not legal advice. Dollar figures are for the year shown and change every January. Confirm with the state Medicaid agency or an elder-law attorney before acting.
- Hard income cap (Miller trust above it)24
- Spend-down (medically needy)13
- Cap or spend-down12
- Other2
| Alabama | Hard income cap (Miller trust above it) | Verified source |
|---|---|---|
| Alaska | Hard income cap (Miller trust above it) | Verified source |
| Arizona | Hard income cap (Miller trust above it) | Verified source |
| Arkansas | Hard income cap (Miller trust above it) | Verified source |
| California | Spend-down (medically needy) | Verified source |
| Colorado | Hard income cap (Miller trust above it) | Verified source |
| Connecticut | Cap or spend-down | Likely |
| Delaware | Hard income cap (Miller trust above it) | Verified source |
| District of Columbia | Cap or spend-down | Verified source |
| Florida | Hard income cap (Miller trust above it) | Verified source |
| Georgia | Hard income cap (Miller trust above it) | Verified source |
| Hawaii | Spend-down (medically needy) | Verified source |
| Idaho | Hard income cap (Miller trust above it) | Verified source |
| Illinois | Spend-down (medically needy) | Likely |
| Indiana | Hard income cap (Miller trust above it) | Verified source |
| Iowa | Hard income cap (Miller trust above it) | Verified source |
| Kansas | Cap or spend-down | Verified source |
| Kentucky | Hard income cap (Miller trust above it) | Verified source |
| Louisiana | Cap or spend-down | Verified source |
| Maine | Spend-down (medically needy) | Unconfirmed |
| Maryland | Spend-down (medically needy) | Likely |
| Massachusetts | Other | LikelySecondary source |
| Michigan | Cap or spend-down | Verified source |
| Minnesota | Spend-down (medically needy) | Unconfirmed |
| Mississippi | Hard income cap (Miller trust above it) | Verified source |
| Missouri | Spend-down (medically needy) | Likelyarchived copy of official page, 2026-10-19 |
| Montana | Spend-down (medically needy) | Verified source |
| Nebraska | Spend-down (medically needy) | Verified source |
| Nevada | Hard income cap (Miller trust above it) | Verified source |
| New Hampshire | Spend-down (medically needy) | LikelySecondary source |
| New Jersey | Hard income cap (Miller trust above it) | Verified source |
| New Mexico | Hard income cap (Miller trust above it) | Verified source |
| New York | Spend-down (medically needy) | Verified source |
| North Carolina | Other | Verified source |
| North Dakota | Spend-down (medically needy) | Verified source |
| Ohio | Hard income cap (Miller trust above it) | Verified source |
| Oklahoma | Hard income cap (Miller trust above it) | Verified source |
| Oregon | Hard income cap (Miller trust above it) | Verified source |
| Pennsylvania | Cap or spend-down | Verified source |
| Rhode Island | Cap or spend-down | Verified source |
| South Carolina | Hard income cap (Miller trust above it) | Verified source |
| South Dakota | Hard income cap (Miller trust above it) | Verified source |
| Tennessee | Hard income cap (Miller trust above it) | Verified source |
| Texas | Hard income cap (Miller trust above it) | Verified source |
| Utah | Spend-down (medically needy) | Verified source |
| Vermont | Cap or spend-down | Verified source |
| Virginia | Cap or spend-down | Verified source |
| Washington | Cap or spend-down | Likely |
| West Virginia | Cap or spend-down | Verified source |
| Wisconsin | Cap or spend-down | Likely |
| Wyoming | Hard income cap (Miller trust above it) | Verified source |