Can Medicare take your home to pay for nursing home care?

A fellow caregiver asked...

Can Medicare take your home? My husband has cancer. I want to protect our assets which really are just our home. We do not have stocks or bonds.We have just a retirement income of $4000 per month and combined Social Security of $300 per month. So we have very limited income.We want to protect our home from having to be sold in case either of us has to go into a nursing home.It is deeded to both of us.What should we do to protect our only asset from the government. How can I protect our home from Medicare?

Expert Answer

Short-term nursing skilled facility care can be covered by Medicare during treatment or recovery following a hospital stay. Medicare doesn't seek reimbursement for any nursing facility costs, so your home wouldn't be at risk.

Long-term nursing home care is a different story – Medicare doesn't cover it, but Medicaid does. For one spouse to qualify for Medicaid nursing home coverage, the combined income and assets of both spouses have to be low – the exact amounts vary from state to state, but the at-home spouse would not be able to keep the full $4,300 per month combined that you now get. As long as one spouse lives in a house, that house is not counted in determining Medicaid eligibility, and Medicaid doesn't require the at-home spouse to use any of the value of the house to pay for nursing home costs. However, once you both leave the house permanently, Medicaid can seek reimbursement from the value of the house for any amounts it's paid for nursing home care. One way to avoid this Medicaid reimbursement is to deed the house out of the nursing home spouse's name more than 60 months before he or she applies for Medicaid coverage of the nursing home care.