This page provides a plain-English summary of key elder care and estate planning information specific to Alaska residents. It covers Alaska Medicaid limits, estate tax rules, advance directive information, and links to important Alaska agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
Alaska Medicaid — 2026 Eligibility Limits for Long Term Care
Alaska’s Medicaid program is called DenaliCare and is administered by the Alaska Department of Health — DOH. Alaska expanded Medicaid under the Affordable Care Act in 2015 providing coverage to adults up to 138 percent of the federal poverty level. Alaska uses higher Federal Poverty Level thresholds than the lower 48 states reflecting the state’s significantly higher cost of living. As of January 2026 over 61,000 Alaskans are covered under Medicaid expansion.
Important — Alaska has the highest nursing home costs in the country Alaska has the highest nursing home costs in the nation at approximately $25,000 per month — significantly exceeding even Hawaii which is second highest. The extreme cost of providing care in Alaska’s remote environment along with high labor costs and the expense of transporting supplies drives these extraordinary costs. Planning ahead for long term care is especially critical for Alaska residents given these costs.
Income limit — single applicant The income limit for a single Alaska nursing home Medicaid applicant is $2,982 per month in 2026. Alaska is an income cap state meaning applicants whose income exceeds this limit must establish an Irrevocable Income Trust — Alaska’s term for a Qualified Income Trust or Miller Trust — to qualify.
Asset limit — single applicant A single applicant must have $2,000 or less in countable assets. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, and irrevocable funeral trusts. Note that IRAs and 401(k)s are counted as countable assets for the applicant in Alaska. However the non-applicant spouse’s IRA or 401(k) is exempt — a favorable rule for married couples.
Home and community based care — HCBS Waiver Alaska’s HCBS program provides home and community based services for Alaska residents who need nursing facility level care but want to remain at home or in a community setting. The asset limit is $2,000 for a single applicant and the income limit is $2,982 per month. Given Alaska’s vast geography and remote communities the HCBS Waiver is especially important as nursing facility options may be limited or require relocation to another community.
Alaska Native Tribal Health System Alaska Native and American Indian residents may access health care including long term care services through the Alaska Native Tribal Health System — ANTHC — and tribal health organizations. This system provides a separate pathway for health services for eligible Alaska Natives and may coordinate with DenaliCare Medicaid for long term care coverage. Alaska Native elders and their families should contact their local tribal health organization for information about available services.
Married couples — one spouse applying When only one spouse applies for Alaska Medicaid the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined countable assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $2,000.
Monthly Maintenance Needs Allowance Alaska uses the federal maximum Monthly Maintenance Needs Allowance of $4,066.50 per month in 2026. Given Alaska’s high cost of living many community spouses in Alaska will qualify for income closer to or at the maximum allowance.
Personal needs allowance — highest in the country Alaska nursing home Medicaid recipients are allowed to keep $200 per month as a personal needs allowance — the highest personal needs allowance in the country. The remainder of income is applied toward the cost of care.
Look-back period and divestment penalty Alaska has a 60-month — five year — look-back period for nursing home Medicaid and HCBS Waiver applications. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. Alaska’s divestment penalty divisor reflects its extraordinarily high average monthly nursing home costs — producing very short penalty periods for equivalent transfer amounts compared to lower-cost states.
Estate recovery Alaska requires Medicaid estate recovery. After a DenaliCare recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney is especially important in Alaska given the high value of real estate and the significant cost of care.
How to apply for Alaska DenaliCare Medicaid Applications can be submitted online through the Alaska myAlaska portal at mybenefits.alaska.gov, by phone at 1-800-780-9972, or in person at your local Alaska Department of Health office.
Alaska Medicaid administering agency Alaska Department of Health — health.alaska.gov
Alaska Estate Tax — 2026
Alaska is one of the most tax-favorable states in the country — with no state income tax no estate tax no inheritance tax and no statewide sales tax. Alaska is also unique in that it pays residents an annual dividend simply for living there.
No Alaska state estate tax Alaska does not impose a state estate tax. No Alaska estate tax applies to any estate regardless of size.
No Alaska inheritance tax Alaska does not impose an inheritance tax. Beneficiaries who receive assets from an Alaska decedent owe no Alaska inheritance tax regardless of the size of the inheritance or their relationship to the deceased.
Federal estate tax Alaska residents may be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses meaning a married couple can protect up to $30,000,000 from federal estate tax with proper planning. The top federal estate tax rate is 40 percent on amounts above the exemption.
No Alaska income tax Alaska has no state income tax of any kind. Social Security benefits pension income IRA distributions wages and all other personal income are completely free from Alaska state income tax. Alaska is one of only nine states with no income tax.
No Alaska statewide sales tax Alaska has no statewide sales tax — one of only five states without one. However Alaska municipalities can and do impose their own local sales taxes of up to 9.5 percent. The average combined local sales tax rate in Alaska is below 2 percent statewide though rates vary significantly by community.
No Alaska gift tax Alaska does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026.
Alaska Permanent Fund Dividend — unique to Alaska Alaska is the only state in the country that pays its residents an annual dividend simply for living there. The Alaska Permanent Fund Dividend — PFD — is funded by investment returns on Alaska’s oil wealth held in the Alaska Permanent Fund — a fund with over $78 billion in assets. Eligible Alaska residents who have lived in the state for at least one full calendar year and meet other requirements receive the annual PFD. The 2025 PFD was $1,000 per eligible resident. A family of four eligible residents receives approximately $4,000 per year in PFD payments. The PFD is taxable as ordinary income on federal tax returns. The amount varies each year based on fund performance and legislative decisions.
Alaska property taxes — varies significantly by community Alaska has no statewide property tax. Property taxes are levied only by municipalities and boroughs and vary widely. The average effective property tax rate statewide is approximately 1.04 percent — near the national average. However many rural Alaska communities and the unorganized borough have no property tax at all. Most Alaskan municipalities offer property tax exemptions for senior citizens aged 65 and older.
Step-up in basis Inherited assets in Alaska receive a stepped-up tax basis to fair market value at the date of the original owner’s death. This can significantly reduce capital gains taxes when beneficiaries later sell inherited property including Alaska real estate and mineral rights.
Alaska Advance Directives
Alaska law recognizes the following advance directive documents:
Alaska Advance Health Care Directive Alaska uses a combined Advance Health Care Directive that includes both the appointment of a healthcare agent and treatment instructions. Must be signed and witnessed by two adults or notarized.
Alaska POLST — Physician Orders for Life-Sustaining Treatment Alaska uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or nurse practitioner.
Alaska Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. Alaska has standardized out-of-hospital DNR protocols.
Alaska Advance Directive Registry Alaska does not maintain a statewide advance directive registry. Copies of your advance directive should be given to your healthcare agent physician and any hospital or care facility where you receive care.
Free Alaska advance directive forms Free Alaska-specific advance directive forms are available at caringinfo.org and from the Alaska State Medical Association at ak.westernjournalmedicine.com.
Alaska Key Agencies and Resources
Alaska Department of Health — DOH Administers DenaliCare — Alaska Medicaid — including long term care programs. Website: health.alaska.gov myAlaska Benefits Portal: mybenefits.alaska.gov Phone: 1-800-780-9972
Alaska Division of Senior and Disabilities Services — SDS Coordinates programs and services for older Alaskans including home care nutrition programs caregiver support and the Alaska SHIP program for free Medicare counseling. Website: dhss.alaska.gov/dsds Phone: 1-907-465-4879 Alaska SHIP — free Medicare counseling: 1-800-478-6065
Alaska Area Agencies on Aging Alaska is served by Area Agencies on Aging that coordinate local services for older adults and caregivers across the state’s vast geography. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
Alaska Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: dhss.alaska.gov/dsds/ombudsman Phone: 1-907-334-4480
Alaska Bar Association Lawyer Referral Service Connects Alaskans with attorneys including those who specialize in elder law and estate planning. Website: alaskabar.org Phone: 1-907-272-0352
Alaska Legal Services Corporation Provides free civil legal services to low income Alaskans including seniors on issues related to Medicaid benefits housing and elder law. Website: alaskalegalservices.org Phone: 1-888-478-9547
Alaska Veterans Resources
Alaska Department of Military and Veterans Affairs — DMVA Provides services and benefits to Alaska veterans and their families including free VA claims assistance and connections to Alaska veterans resources. Website: dmva.alaska.gov Phone: 1-907-428-6016
Alaska Veterans and Pioneers Home Alaska operates veterans and pioneers homes providing long term care to eligible veterans and their spouses. Facilities are located in Palmer and Sitka. Website: dmva.alaska.gov/veterans-homes
Alaska Senior Property Tax Benefits
Senior Citizen Property Tax Exemption Most Alaska municipalities offer property tax exemptions for qualifying senior citizens aged 65 and older. Exemption amounts and eligibility requirements vary significantly by municipality. Contact your local assessor for details on programs available in your community.
Anchorage Senior Property Tax Exemption Anchorage homeowners aged 65 and older who have owned and occupied their home as their primary residence for at least one year qualify for an exemption on the first $150,000 of assessed value of their primary residence. Apply through the Municipality of Anchorage assessor’s office.
Disabled Veteran Property Tax Exemption Most Alaska municipalities offer property tax exemptions for qualifying disabled veterans. Contact your local assessor for details.
Finding Elder Law and Estate Planning Attorneys in Alaska
The following resources can help you find a qualified elder law or estate planning attorney in Alaska:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- Alaska Bar Association Lawyer Referral Service — alaskabar.org — 1-907-272-0352
- Alaska Chapter of NAELA — Alaska has an active NAELA chapter with members throughout the state
- Alaska Legal Services Corporation — alaskalegalservices.org — free legal assistance for income-qualifying seniors — 1-888-478-9547
The information on this page is for general informational purposes only and does not constitute legal or financial advice. Alaska DenaliCare Medicaid rules and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: May 2026