Common questions about Medicaid and long-term care

Myth: Medicare will pay for long-term nursing-home care.
Reality: Medicare may cover short-term skilled nursing care when its coverage requirements are met, but it is not a long-term custodial-care program. Medicaid is the primary public program that may help cover long-term nursing-facility care for a person who meets its medical and financial rules.

Myth: I have to spend everything before I can qualify.
Reality: Medicaid’s financial rules are strict, but they also contain protections for certain assets and for a spouse who remains at home. The available planning options depend on the family structure, the type of assets, and when care is needed.

Myth: I should give my money or home to my children now.
Reality: A transfer for less than fair market value during Medicaid’s look-back period can create a penalty period. Do not move money, add names to accounts, or sign a deed based on general advice. A transfer that helps one family may create a serious problem for another.

Myth: A prenuptial agreement keeps one spouse’s assets out of Medicaid eligibility.
Reality: A marital agreement may determine ownership rights between spouses, but it does not necessarily control how Medicaid treats resources. Medicaid applies its own rules when evaluating a married applicant.

Myth: A will or revocable living trust protects assets from nursing-home costs.
Reality: A will generally controls what happens at death, not what is available during life. Assets in a revocable trust are generally treated as available to the person who created the trust. Other planning tools may be appropriate, but the details matter.

Myth: Medicaid means I must sell my home.
Reality: A home may be excluded while an applicant is living, subject to Medicaid’s rules and the facts of the case. That does not end the analysis: ownership, equity, occupancy, spouse and dependent protections, and estate-recovery issues can all matter. Get advice before selling, transferring, or changing title to the home.