Medicaid comes after homes

Given the very high cost of extended care (and the thrifty nature of some METARs which causes them to minimize their income by investing in stocks) it’s possible that some of us may turn to Medicaid. Actually, unlike Obamacare, Medicaid looks at assets rather than income. But the home is exempted from the asset list.

When Medicaid Comes After the Family Home

Federal law requires states to seek reimbursement from the assets, usually homes, of people who died after receiving benefits for long-term care.
By Paula Span, The New York Times, March 16, 2024

The daughter moved into the family’s Midwestern home years earlier, when her widowed mother, who had vascular dementia, began to need assistance.

Her mother was well insured, with Medicare, a private supplemental “Medigap” policy and long-term care insurance. The only reason she enrolled in Medicaid was that she had signed up for a state program that allowed her daughter to receive modest payments for caregiving.

But that triggered additional monthly charges through a Medicaid managed care organization, and now the state wants that money back [potentially forcing the sale of the home]…[end quote]

The claw-back practice dates to 1993, when Congress mandated that when Medicaid beneficiaries over age 55 have used long-term services, such as nursing homes or home care, states must try to recover those expenses from the beneficiaries’ estates after their deaths. Since Medicaid requires that beneficiaries only have $2,000 in assets (other than a home and car) the claw-back usually comes from sale of the home.

The lesson here is to read the fine print if you (or someone you know) plans to use Medicaid for long-term care.



If Private Equity is getting a cut, you’re screwed.


My understanding is that Medicaid can’t
take the home of a married couple if one of them runs up the bill.

Good that gays can get married.
It protects the surviving spouse’s home.
The law should be changed to allow siblings or parent and child that have lived together forever to experience these benefits.

It is also a reason that couples that have lived together for years finally get married to protect assets as the twilight approaches.