Guides › Medicaid and Your House
Updated July 31, 2026. Quick answer: “can Medicaid take the house” is really TWO questions with different timelines, and most articles blur them. Before and during care: the home is usually an EXEMPT asset — it does not count against eligibility while a spouse, minor, or disabled child lives there, or while you declare an intent to return (subject to an equity cap, roughly $700,000–$1.1 million depending on state, indexed annually). Medicaid does not “take” the house while you are alive. After death: every state must run an estate-recovery program that claims long-term-care costs back from your estate — and whether that claim can reach a house that passed OUTSIDE probate depends entirely on your state, which is what the table below verifies.
The two programs people conflate
The 60-month look-back polices GIFTS before applying: transfers within five years create a penalty period computed by a federal formula. Estate recovery happens after death. Different rules defeat each: the look-back is about timing and exempt transfers (including the caregiver-child exemption); recovery is about what ends up in the probate estate — which is why TOD deeds and Lady Bird deeds matter in some states and fail in others. One special case: California eliminated its asset limit in 2024 and narrowed both programs sharply — Californians should read state guidance, not national articles.
Estate-recovery reach, verified state by state
29 of 51 jurisdictions recover only from the probate estate; 22 have adopted expanded recovery reaching some non-probate transfers. Crossed with whether the state offers a TOD deed (from our statute-verified 51-state table):
| State | Estate-recovery reach | TOD deed available | What that means for the house |
|---|---|---|---|
| Alabama | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Alaska | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Arizona | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Arkansas | Probate estate only † | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| California | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Colorado | Probate estate only † | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Connecticut | Probate estate only † | No | Sources conflict on this state’s reach — confirm with the state Medicaid agency before relying on any deed strategy |
| Delaware | Probate estate only † | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| District of Columbia | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Florida | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Georgia | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Hawaii | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Idaho | EXPANDED (beyond probate) | No | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Illinois | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Indiana | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Iowa | EXPANDED (beyond probate) | No | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Kansas | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Kentucky | EXPANDED (beyond probate) | No | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Louisiana | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Maine | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Maryland | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Massachusetts | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Michigan | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Minnesota | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Mississippi | Probate estate only † | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Missouri | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Montana | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Nebraska | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Nevada | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| New Hampshire | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| New Jersey | EXPANDED (beyond probate) | No | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| New Mexico | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| New York | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| North Carolina | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| North Dakota | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Ohio | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Oklahoma | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Oregon | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Pennsylvania | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Rhode Island | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| South Carolina | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| South Dakota | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Tennessee | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Texas | Probate estate only | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Utah | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Vermont | Probate estate only | No | Assets passing outside probate (no TOD deed (check Lady Bird availability), living trusts, joint tenancy) are generally beyond recovery here |
| Virginia | EXPANDED (beyond probate) † | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Washington | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| West Virginia | Probate estate only † | Yes | Assets passing outside probate (a TOD deed, living trusts, joint tenancy) are generally beyond recovery here |
| Wisconsin | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
| Wyoming | EXPANDED (beyond probate) | Yes | Expanded recovery: assume non-probate transfers may be reachable; get state-specific advice |
† = one authority or conflicting sources; confirm with the state Medicaid agency. This table describes recovery SCOPE; hardship waivers, surviving-spouse deferrals, and lien programs vary further. Data licensed CC BY 4.0 — reuse with attribution and a link.
What actually protects the house
In probate-only states: keeping the house OUT of probate (a TOD or Lady Bird deed where available, a properly built trust) generally puts it beyond recovery — but adding a child to the deed is usually the worst way to try. In expanded states, planning is harder and earlier: five-year-old transfers clear the look-back, and irrevocable-trust work is exactly the kind of thing to do with professional help, not a blog post.
The house is usually the family’s largest asset – and the rules protecting it are state-specific and unforgiving of timing.
Five years is the planning horizon; the best time to get advice is before anyone needs care. The matching service below introduces you to advisers who pay to meet you.
Before you start, what actually happens. The form is run by Kapitalwise, our advisor-matching partner. It asks about nine questions — age, investable assets, location — then your name, email and phone number, and verifies the phone by text.
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The number that surprises people who bought a long time ago
Downsizing is the one home sale where the gain is usually large and the exclusion usually still covers it. A couple who bought in 1994 for $180,000 and sell at $760,000 with $46,000 of selling costs have a realized gain of about $534,000 before improvements. That is above the $500,000 joint cap — but decades of capital improvements are exactly what brings it back under, and most sellers have never added them up.
Improvements are the lever, and the records are the constraint
A new roof, an addition, a replaced HVAC system, new windows, a finished basement: these add to basis. Repainting and repairs do not. Thirty years of improvements on a family home routinely total six figures, and every dollar of it reduces the gain dollar for dollar. The practical problem is documentary, not legal — the seller who kept receipts pays less than the identical seller who did not.
Why downsizers should check the net investment income tax separately
A retiree with modest ordinary income can still be pushed over the 3.8 percent NIIT threshold by the sale itself, because taxable gain is net investment income. The thresholds are $250,000 on a joint return and $200,000 otherwise, written into Section 1411(b) as fixed figures with no indexing. A sale that produces $120,000 of taxable gain on top of $180,000 of other income crosses the joint threshold and picks up 3.8 percent on the part above it.
The move itself may change the tax
Downsizing usually means moving, and sometimes across a state line. Some states tax the gain the federal exclusion just removed. If the sale and the move are in the same year, the order of the two matters, and it is worth checking the destination state before signing.
Related
Methodology
- Exclusion caps, the 2-of-5 test, the nonqualified-use allocation, the reduced-exclusion fraction and the depreciation carve-out are taken from the text of 26 U.S.C. 121. The 3.8 percent rate and its thresholds are from 26 U.S.C. 1411. Both were read on 2026-07-30.
- Section 121 caps and Section 1411 thresholds are written in the statute as fixed dollar amounts with no indexing mechanism, so they are built in. Long-term capital gain brackets ARE indexed annually, so your rate is an input rather than a lookup.
- Figures were computed by two independently written engines that agree to the cent, and the calculator on this page reproduces both exactly.
- Federal only. State treatment varies and some states do not follow the federal exclusion.
Educational estimate, not tax advice, and not a filed return. Federal only. Confirm anything that changes a filing decision with a CPA or tax attorney.
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Related: Lady Bird Deeds and Medicaid: Not a Gift, No Penalty, and (Sometimes) No Recovery.