Free senior care guidance for Triangle families. No cost to you, ever.
Call (984) 205-2995
Raleigh Senior Advisor

What Happens When the Money Runs Out

Spend-down, Medicaid waiver transitions, and why you should ask a community about this before you move in.

Get matched freeCall (984) 205-2995
Home›Costs & Paying›What Happens When the Money Runs Out
Short answer

If private funds run out, the options generally are a Medicaid HCBS waiver for care inside a licensed community, Medicaid nursing facility coverage, or moving to a community that holds a waiver provider agreement. Confirm your state's specific programs before relying on this.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not hold a Medicaid waiver provider agreement will ask your parent to leave when private funds are exhausted — often with short notice, at the point when moving is hardest.

Ask directly: do you hold a Medicaid waiver provider agreement, and how many current residents use it? A community can technically hold an agreement and still have no waiver capacity available.

How families pay for care. NC's CAP/DA waiver pays for in-home services only; State/County Special Assistance (not a Medicaid waiver) helps with adult care home room and board. Read the full explanation →
The local long-term care ombudsman. NC Division of Aging and Adult Services (NCDHHS) runs the Office of the State Long-Term Care Ombudsman, with 16 Offices of the Regional Long-Term Care Ombudsman housed within regional Area Agencies on Aging. covers Wake, Durham, Orange, Chatham, Johnston, Lee and Moore counties at 1-800-310-9777 (Central Pines Regional Council / Triangle J region toll-free Ombudsman line, covering Wake, Durham, Orange, Chatham, Johnston, Lee, and Moore counties); Franklin County is a different region. Read the full explanation →

Questions families ask

What are the asset limits to qualify for nursing facility Medicaid in North Carolina in 2026?

For 2026, the NC DHHS Aged/Blind/Disabled resource limit for nursing facility Medicaid is $2,000 for a single applicant and $3,000 for a married couple where both spouses need coverage, per NC DHHS's Basic Medicaid Eligibility Requirements. These limits are far lower than the ACA expansion Medicaid category's rules and apply specifically to the long-term-care eligibility pathway.

What's the income limit to qualify for nursing home Medicaid in North Carolina?

NC's general nursing facility Medicaid income cap is approximately $2,982/month, derived by applying the standard rule of 300% of the 2026 SSI federal benefit rate ($994/month) used in NC's aged/blind/disabled long-term-care Medicaid category. This is a derived estimate based on the SSA-published 2026 SSI rate rather than a figure independently confirmed in the current MA-2270 policy manual excerpt, so families should verify the exact current figure with NC Medicaid or a county DSS caseworker before relying on it for planning.

How much money can a nursing home Medicaid resident in North Carolina keep for personal expenses each month?

NC's nursing facility Medicaid Personal Needs Allowance (PNA) is $70 per month for an institutionalized individual, or up to $140/month combined for a married couple sharing a room in the same facility. Nursing facility Medicaid residents generally must apply nearly all of their remaining monthly income toward the cost of care beyond this allowance, per the NC DHHS MA-2270 policy manual.

If my father goes into a nursing home in Wake County, how much of the couple's savings can my mother keep?

Under NC's Community Spouse Resource Allowance (CSRA) rules, the spouse remaining in the community can generally keep between $31,584 and $157,920 in countable assets, with the exact amount depending on the couple's total countable resources at the time of the Medicaid application (the 'snapshot' date), separate from the nursing home spouse's own $2,000 asset limit. This protects the at-home spouse from having to spend down the couple's entire savings before the institutionalized spouse can qualify.

How much income can my mother keep at home in Chapel Hill if my father moves into a nursing facility on Medicaid?

NC's Minimum Monthly Maintenance Needs Allowance (MMMNA) rules allow a community spouse to retain between $2,643.75 and $3,948.00 per month in income before excess shelter allowance adjustments, with the institutionalized spouse's income potentially diverted to the community spouse if the community spouse's own income falls below this range. The exact figure depends on the community spouse's housing and utility costs, calculated under the MA-2270 policy manual's shelter allowance formula.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free