Can You Qualify for Medicaid If You Own a House?

You can qualify for Medicaid if you own a house. For most applicants, a primary residence is an exempt asset, so Medicaid ignores its value when deciding whether you meet the program’s financial limits. The complications show up when you need long-term care like a nursing home, because equity caps, transfer rules, and estate recovery can all put the home in play.

Your Home Is Usually Exempt

As long as your home is your principal place of residence, Medicaid does not count its value against the asset limit, regardless of what it’s worth.¹ That’s true whether the house is worth $80,000 or $800,000. The exemption also holds if your spouse, a child under 21, or a blind or disabled child of any age lives there.

Countable assets are a separate question. Bank accounts, investments, and other property you could convert to cash generally count toward the limit, which for a single applicant is commonly around $2,000, though states vary. The house sits outside that math as long as it stays your residence.

What Happens If You Move Into a Nursing Home

Your home stays exempt after you enter a facility as long as you express an “intent to return.” That is a formal statement that you still consider the home your primary residence and plan to go back if your health allows. Under federal rules, it does not matter how long you’ve been in the facility or how unlikely a return actually is. If you cannot express the intent yourself, your spouse, a family member, or a legal representative can do it for you.¹ Skip that step and the home flips from exempt to countable, which can make you immediately ineligible.

The Home Equity Limit for Long-Term Care

Even with the exemption, federal law caps how much equity you can have in your home and still qualify for nursing facility or other long-term care services. The base statutory thresholds were $500,000 and $750,000, adjusted upward each year for inflation.² For 2026, the adjusted range runs from $752,000 to $1,130,000.³ Each state picks a limit within that range, and most use the lower figure.

The equity cap does not apply at all if your spouse, a child under 21, or a blind or disabled child lives in the home.² The home stays fully exempt regardless of value. If your equity exceeds the state’s cap and no qualifying family member lives there, you will not be eligible for long-term care coverage until you bring the equity down, usually through a reverse mortgage or a sale.

Rules for Married Couples

When one spouse needs Medicaid-covered nursing home care while the other stays in the community, federal spousal impoverishment protections apply.⁴ The home is exempt as long as the community spouse lives there, with no equity cap.

Beyond the house, the community spouse can keep a share of the couple’s combined countable assets called the Community Spouse Resource Allowance. For 2026, federal rules set this allowance between $32,532 and $162,660, depending on the state.³ The institutionalized spouse is also allowed to keep a small amount, typically $2,000. Assets above those combined totals generally need to be spent down before Medicaid coverage begins.

Don’t Just Give the House Away: The 60-Month Look-Back

This is where many families make a costly mistake. When you apply for long-term care coverage, Medicaid reviews every asset transfer you made during the previous 60 months. Any transfer for less than fair market value in that window triggers a penalty period during which you are ineligible for coverage.²

The penalty length depends on how much you gave away. Medicaid divides the uncompensated value of the transferred assets by the average monthly cost of nursing home care in your state. Give away a $300,000 home in a state where nursing home care averages $10,000 a month, and you face a 30-month penalty. During that period, you pay for care out of pocket.

The penalty clock does not start until you would otherwise be eligible for Medicaid and need long-term care services. You cannot transfer assets early, run down your remaining savings, and quietly wait out the penalty. It only begins after you have already spent down and applied.

Transfers That Don’t Trigger a Penalty

Federal law lets you transfer your home to certain people without any look-back penalty:

Your spouse. There are no restrictions; a transfer to a spouse is always penalty-free.
A child under 21, or a blind or permanently disabled child of any age. The child’s status must be documented at the time of transfer.
A sibling with an equity interest in the home who lived there for at least one year immediately before you entered a nursing facility.
A caretaker child: an adult son or daughter who lived in your home for at least two years immediately before you entered a facility and provided care that allowed you to stay at home rather than moving to a nursing home sooner. The state decides whether the care requirement is met.

These exceptions come from federal statute, and every state must honor them.² The caretaker child exception is the one families reach for most often, and states scrutinize it the hardest. Expect to produce documentation: proof the child lived at the address, medical records, and a physician’s statement that the care kept you out of a facility.

Transfers outside these categories can still avoid a penalty if you can prove the transfer was made for a reason other than qualifying for Medicaid, or if all transferred assets are returned to you. The burden of proof is on you.

Liens on Your Home While You’re Alive

States can place a lien on your home under certain conditions even before you die. A TEFRA lien applies only to someone determined to be permanently institutionalized, meaning the state has concluded you are not reasonably expected to return home.⁵ Before placing the lien, the state must give you a hearing to contest that determination. If you are later discharged and return home, the lien must be released.

A TEFRA lien cannot be placed if any of the following people live in the home:

Your spouse
A child under 21
A blind or permanently disabled child of any age
A sibling with an equity interest in the home who has lived there for at least one year before your admission

A TEFRA lien does not force an immediate sale. It does mean you cannot sell or transfer the property without first satisfying the state’s claim. States vary in how aggressively they use these liens, and not every state chooses to impose them.

Estate Recovery After You Die

Here is the part that catches families off guard. Federal law requires every state to seek repayment from the estates of Medicaid recipients who were 55 or older and received nursing home services, home and community-based services, or related hospital and prescription drug services.⁶ The home is usually the largest asset in the estate, which makes it the primary target.

Recovery cannot happen while certain people are alive and residing in the home. The state cannot pursue the estate if doing so would affect a surviving spouse, a child under 21, or a blind or disabled child of any age.⁶ Once those protections no longer apply, the state can file a claim against the estate for the full amount Medicaid spent on care.

States must also set up hardship exception procedures. Federal guidance suggests that recovery should be waived when the estate includes a homestead of modest value or income-producing property like a farm or family business essential to the support of surviving family members.⁷ States have significant discretion in defining hardship, so what qualifies varies. If the home would otherwise need to be sold to pay the claim, filing a hardship waiver request is worth pursuing.

Paying to Keep Up a House You Don’t Live In

An often-overlooked problem is how you keep paying for a home you’re not living in. Once you enter a nursing facility, nearly all of your income goes toward your share of care costs. That leaves little for the mortgage, property taxes, homeowner’s insurance, or basic maintenance. Federal rules allow some income to be set aside for home maintenance expenses for a limited time, but the amount and duration are set by each state and are often inadequate.¹

When those expenses go unpaid, the home falls into disrepair, tax liens accumulate, and eventually selling becomes the only realistic option. Married couples usually avoid this problem because the community spouse stays in the home. Single applicants with no one in the house face real financial pressure that can force a sale even though Medicaid still treats the home as exempt on paper. Planning ahead for those costs, whether through family help, rental income, or other arrangements, is what turns the exemption from theoretical into real.

1
Office of the Assistant Secretary for Planning and Evaluation (ASPE). Medicaid Treatment of the Home: Determining Eligibility and Repayment for Long-Term Care
2
Office of the Law Revision Counsel. 42 USC 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets
3
Department of Health and Human Services. 2026 SSI and Spousal Impoverishment Standards
4
Medicaid.gov. Spousal Impoverishment
5
Department of Health and Human Services. Medicaid Liens
6
Medicaid.gov. Estate Recovery
7
Office of the Assistant Secretary for Planning and Evaluation (ASPE). Medicaid Estate Recovery