Medicaid Long-Term Care
15 deep guides to Medicaid long-term care planning.
Medicaid Long-Term Care Eligibility
Medicaid LTC eligibility requires meeting both a medical threshold (nursing-home level of care) and strict financial thresholds (income and …
5-Year Medicaid Look-Back
Medicaid reviews 60 months of asset transfers before an LTC application. Improper transfers create a penalty period of ineligibility equal t…
Spousal Impoverishment Protection
When one spouse needs Medicaid LTC, spousal impoverishment rules protect the community spouse's income and assets — typically half of counta…
Medicaid Estate Recovery
After a Medicaid LTC recipient dies, states must attempt to recover long-term care costs from the estate. The primary residence is often the…
Miller Trusts (Qualified Income Trusts)
In income-cap states (about 22), applicants with income above the Medicaid limit can create a Miller Trust — a Qualified Income Trust — to r…
Caregiver Child Exception
A home transfer to an adult child who lived in the home and provided care that delayed institutionalization for at least 2 years is exempt f…
Sibling Caregiver Exception
A home transfer to a sibling with an equity interest who lived in the home 1+ year is exempt from look-back penalty.…
Irrevocable Trusts for Medicaid Planning
Assets in a properly structured irrevocable Medicaid Asset Protection Trust (MAPT) can be protected from look-back after the 5-year window.…
Medicaid Home Equity Limits
Federal Medicaid rules allow states to cap home equity at $688,000 or $1,033,000 (2023 figures). Equity above this cap disqualifies an appli…
Medicaid HCBS Waivers
Home and Community-Based Services (HCBS) waivers let states cover long-term services at home or in assisted living instead of institutional …
Medicaid-Compliant Annuities
A properly structured single-premium immediate annuity (SPIA) can convert excess assets to income, protect the community spouse, and avoid M…
Medicaid Spend-Down
Spend-down is the process of reducing countable assets to meet Medicaid eligibility. Allowed expenditures include care costs, home repairs, …
Medicaid Income-Cap States
About 22 states use an income cap for LTC Medicaid eligibility. Applicants with income above the cap must use a Miller Trust to qualify.…
VA Aid & Attendance for LTC
VA Aid & Attendance is a pension benefit for wartime veterans and surviving spouses who need help with daily activities. It can help pay for…
LTC Insurance vs Relying on Medicaid
LTC insurance preserves provider choice and asset flexibility. Medicaid is the safety net but limits care setting, provider network, and for…