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Will Medicaid Take Your House? Nursing Home Care, the Look-Back, and Estate Recovery

By CalculateBenefits Editorial Team · Mark Phaneuf, Publisher
AI-assisted source check: September 29, 2026. What these dates mean.

Usually not while the person is alive. For nursing home Medicaid, the home often does not count if you, your spouse, or a dependent relative lives there, or if you plan to go back. But a state may put a lien on the home in some cases, and after death it may try to get paid back from the estate, which can include the house.

Your state Medicaid office decides each case.

Does Medicaid take your house when you go into a nursing home?

Moving into a nursing home does not by itself mean you lose the home. Medicaid counts what you own. But your main home is often left out when:

• You still live there.
• Your spouse or a dependent relative lives there.
• You plan to go back home.

States judge plans to go home in different ways. If none of these apply, the home may count as an asset. Then you may lose Medicaid for a time, or need to use its value for your care.

Is there a home equity limit in 2026?

Yes. Equity is what the home is worth minus what you still owe on it. If your equity is over the state's limit, Medicaid may not pay for your nursing home care.

In 2026, the federal limit is at least $752,000. A state may pick a higher limit, up to $1,130,000.

This limit does not apply if a spouse, a child under 21, or a blind or disabled child lives in the home. States can also make an exception for hardship.

A 2025 federal law changes the top limit. Starting January 1, 2028, it will be $1,000,000 for most homes, and it will stop rising each year. Homes on land zoned for farming may have a different limit.

How many years does Medicaid look back?

Five years. The state checks the 60 months before you apply for nursing home Medicaid.

It looks for things you or your spouse gave away or sold for less than they were worth. Cash gifts to children can count. So can putting your home in someone else's name.

If the state finds this, it sets a penalty period. During that time, Medicaid will not pay for nursing home care.

How is the penalty figured?

1. The state adds up what was given away in the look-back.
2. It divides that by the state's average monthly cost of nursing home care for people who pay on their own.
3. The result is how many months Medicaid will not pay for that care. Part of a month counts too.

So a gift worth three months of care means about a three-month wait.

The penalty does not start until you are in nursing home care and would qualify for Medicaid if not for the gift.

A state may waive the penalty if it would put your health or life at risk, or leave you without food, clothing, or shelter. This is called undue hardship. A nursing home can ask for this for you, with your consent.

A few home transfers, such as one to a spouse, have no penalty. Ask the state or a lawyer before you move any property.

How does Medicaid spend down work?

"Spend-down" can mean two things.

Using up savings. Many people pay for care with their own money until they spend enough to qualify. In most states, a single person can keep only about $2,000 in countable assets. Paying a fair price for the person's own care and bills is not a gift. Ask the state before you pay a relative for care. Keep every receipt. The state may ask you to explain changes in your assets over the past five years.

Medical bills over the income limit. Some states let people with too much income still qualify. Their medical bills must first use up the extra income. This is often called a medically needy program. Thirty-six states and Washington, D.C., use some kind of spend-down.

How do you qualify for Medicaid nursing home care?

You must meet two kinds of rules.

1. Care needs. Each state sets rules for who needs nursing home care. The state checks how much help you need each day.
2. Money rules. The state counts your income and assets.

Most states use a higher income limit for people in nursing homes. It can be up to three times the SSI payment. In 2026, that is $2,982 a month for one person. Your state sets its own limit. If your income is higher, ask the state about other ways to qualify.

If you qualify, the state sends a letter. It lists your start date and how much you must pay toward your care each month. Much of your income may go to the nursing home. You keep at least $30 a month for personal needs.

The state usually has 45 days to decide.

Timing matters too. Today, Medicaid may pay for up to three months before the month you apply, if you would have qualified then. A 2025 federal law cuts this for applications made on or after January 1, 2027. Then the limit is two months, or one month for some adults under 65.

What can the spouse at home keep?

Special rules protect the spouse who still lives at home. They are called spousal impoverishment rules.

Savings. The spouse at home keeps a share of the couple's countable assets. In 2026, the protected amount is at least $32,532 and no more than $162,660. States set the exact amount. For example, Pennsylvania uses half of the couple's countable assets, within those limits.

Income. Some of the nursing home spouse's income can go to the spouse at home. The goal is to bring that spouse up to a set monthly amount. Starting July 1, 2026, that amount is at least $2,705 in most states. It is higher in Alaska and Hawaii. The 2026 cap is $4,066.50 a month.

Can Medicaid put a lien on your house?

In some cases, yes. A lien is a legal claim against a home. A state may place one if the Medicaid member is in a nursing home for good.

It may not do this while any of these people live there:

• A spouse
• A child under 21
• A blind or disabled child of any age
• A brother or sister who owns part of the home

If the person leaves the nursing home and moves back home, the state must remove the lien.

What happens to the house after the person dies?

Each state must try to get back some Medicaid costs from a member's estate. This applies to care paid for when the member was 55 or older. It is called estate recovery.

The estate includes what goes through probate, the court process after a death. That can be the house. Some states reach more, like a home held in joint names or in a living trust.

Federal law protects some families:

• The state may not recover while a surviving spouse is alive.
• It may not recover while there is a surviving child under 21, or a blind or disabled child of any age.
• In some cases, it may not take the home while a brother or sister, or a grown child who gave care, still lives there.

Some of these rules only delay recovery. For example, some states may try to recover after the spouse dies.

States must also offer a hardship waiver. Examples include a home of modest value, or a family farm or business the family needs to live on. Ask the state how to apply and by what date.

How long can you stay in a nursing home with Medicaid?

Generally, for as long as the person still meets the rules. Coverage usually ends the month they no longer do. States must cover nursing home care for adults 21 and older who need it. They may not put people on a waiting list for it.

Medicare is different. It pays only for a short stay in a skilled nursing facility, usually after a hospital stay of at least three days. It covers up to 100 days in each benefit period. In 2026, Original Medicare charges $217 a day for days 21 through 100. Medicare does not pay for long-term care.

How can you pay for a nursing home without Medicaid?

Most people start by paying out of pocket, with savings and income. Other ways to pay include:

• Long-term care insurance. Policies vary, so check what yours covers.
• Life insurance. Some insurance companies let you use a life policy to pay for long-term care.

Even with savings or insurance, you may spend down your assets over time. So it helps to pick a home that takes Medicaid.

What should your family do next?

1. Call your state Medicaid office. Find it on Medicaid.gov. Ask how your state treats the home, gifts, and estate recovery.
2. Call the Eldercare Locator at 1-800-677-1116. It can point you to local help for older adults, like your Area Agency on Aging.
3. Look for legal aid. Groups paid for by the Legal Services Corporation give free legal help to people with low income. If you hire a private elder law attorney, ask about the fee first.
4. Gather records. For the home, the state may ask for a tax bill, an appraisal, or mortgage papers.

It is free to apply for Medicaid. Be careful of anyone who charges just to fill out forms or promises to "save the house." Do not hide assets. Gifts made in the five years before you apply can bring a penalty.

For the basics, read our Medicaid eligibility guide. If you are helping a mom or dad, see our guide to helping an aging parent apply for benefits. CalculateBenefits is not a government agency, and this guide is not legal advice.