Many Americans worry about how they’ll cover costly nursing home stays or long-term care later in life. After all, the monthly median cost of a private room in a nursing home facility is $9,733, according to Genworth’s 2023 Cost of Care Survey — and demand isn’t slowing.
Based on a report from the Urban Institute and the U.S. government, 70% of adults who survive to age 65 end up requiring long-term support while 48% receive some paid care over their lifetime.
Medicaid, a federal health insurance benefit for low-income Americans, will cover services at most nursing homes (limited to medically necessary care). But, the beneficiary must give up most of their income, minus a monthly stipend. So how does that impact the beneficiary’s spouse? Can the state try to recoup its costs by seizing the marital home?
Say, for example, a woman’s 65-year-old husband is going into a nursing home, which costs $13,000 a month. While Medicaid will cover the nursing home payments, she’s worried that the state will seize her home and force her to sell it in order to recover those costs — leaving her out in the cold. Here’s what she needs to know.
If you’re 55 or older when receiving Medicaid (or an individual of any age who is permanently institutionalized), states are required to “seek recovery of payments from the individual’s estate for nursing facility services, home and community-based services, and related hospital and prescription drug services,” according to Medicaid.gov.
While Medicaid will pay for nursing care, the state will attempt to recover its debt through estate recovery. If the Medicaid recipient passes away or isn’t expected to return home, Medicaid can place a lien on the home.
While the framework for Medicaid falls under federal law, each state applies those rules a bit differently. For example, in one state, a lien could be placed on the home while the beneficiary is still alive. In another, a lien wouldn’t be placed until the beneficiary has passed away. And some states don’t use liens.
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