Medicaid and LTC

MEDICAID ELIGIBILITY rules vary from state to state. But no matter where you live, before Medicaid starts paying your nursing home expenses, you will be expected to put much of your income and assets toward covering the cost.

A major exception is your primary home. Depending on the state, between $713,000 and $1.071 million in home equity may be protected in 2024. The house should also be exempt if your spouse, children under age 21, or a blind or disabled child of any age live there. If you are married, the at-home spouse can often keep all income that’s solely in his or her name. The spouse who isn’t in a nursing home may also be eligible to keep up to $154,140 of the couple’s joint assets in 2024 and, depending on how much other income he or she has, retain up to $3,853.50 of the institutionalized spouse’s monthly income.

To qualify for Medicaid, you might be tempted to transfer assets to family members. But those transfers need to occur more than five years before you apply for Medicaid or you could be penalized. Let’s say you recently transferred $70,000 to your children and the monthly cost for a local nursing home is $7,000, so you effectively gifted 10 months’ worth of nursing home expenses. Even if you are eligible for Medicaid based on your current financial situation, Medicaid won’t pay your nursing home costs for 10 months after you apply for assistance.

After you die or, if married, after your spouse dies, federal law requires that your state try to recover your Medicaid-paid nursing home costs from your estate. States also have the option to try to recover other Medicaid costs. Want more information? Head to

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