"If I get Medicaid, can the state take my home?" This is a common concern among older adults and their caregivers. In most cases, the answer is no.

Simply enrolling in Medicaid doesn't mean you'll lose your home. However, after a Medicaid beneficiary dies, states may seek repayment for certain long-term care costs through a process called estate recovery. Federal law also includes important protections for surviving spouses, certain children, and other qualifying family members.

Who does Medicaid estate recovery affect?

Medicaid estate recovery generally applies to people who are receiving certain Medicaid benefits at age 55 or older and to people of any age who are permanently institutionalized. It most often comes into play for older adults who receive Medicaid-covered long-term services and supports (LTSS).

States can also pursue estate recovery for other Medicaid services for these people, except for payment of Medicare premiums (see below).

Medicaid Estate Recovery at a Glance

• Estate recovery usually happens after death.
• It mainly applies to certain long-term care Medicaid benefits.
• States cannot recover assets if certain protected family members still live in the home.
• Rules vary by state.
• Hardship waivers may be available.

One way to think about estate recovery is that Medicaid “loans” beneficiaries financial support for long-term services and supports, and once the person becomes permanently institutionalized or passes away, the interest-free loan becomes due back to the state. 

Get the facts about estate recovery.

How does estate recovery work?

When a Medicaid beneficiary dies, the value of their estate (if they have one) is used to pay back debts before transferring to any heirs. The estate includes any assets, such as a home or savings or retirement account, that are solely in the name of the beneficiary. Depending on your state’s rules, jointly owned property, living trusts, and other assets can also be subject to estate recovery. 

If the person has no assets at the time of death, there is nothing else the state can do. The state cannot ask the beneficiary’s living heirs for repayment if there is no estate.

Also, if the beneficiary has a spouse living in the community, a certain amount of their combined resources is protected for that spouse, so they are able to continue living independently. This is called the “spousal impoverishment” provision. In 2026, it protects assets worth up to $162,660.

Can Medicaid take away someone’s home?

Part of the estate recovery process looks at property owned by the Medicaid beneficiary and recovering some of the debt through the value of that property (this is called putting a lien on the house).

The state can file a lien when the Medicaid recipient is placed in residential care and not expected to return home, or after the beneficiary’s death. The lien is removed if the beneficiary returns home or the house is sold and Medicaid is reimbursed. Some states only put a lien on the home when the beneficiary is alive; others do this after death.

Who is protected from Medicaid estate recovery?

Even when estate recovery applies, federal law provides important protections for certain family members. In many situations, the state can't recover Medicaid costs—or must delay recovery—if any of the following people are involved:

• A surviving spouse: States can't pursue estate recovery while your spouse is still living.
• A child under age 21: Recovery is delayed until the child reaches adulthood.
• A child of any age who is blind or has a disability: Federal law protects these children from estate recovery.
• A qualifying sibling: In some cases, a sibling who has an ownership interest in the home and lived there for at least one year before you entered a nursing facility may prevent the state from placing a lien on the property.

In addition, every state must offer a process for requesting an undue hardship waiver. If estate recovery would create a significant financial hardship for your heirs, they may be able to ask the state to reduce or waive recovery. Each state sets its own rules for what qualifies as a hardship and sets its own application process for requesting hardship waivers.

Because estate recovery laws vary by state, the answer to many questions depends on where you live. It's important to contact your state Medicaid agency or a qualified benefits counselor to understand how these protections apply where you live.

Does estate recovery apply to all Medicaid benefits?

No. It is important to understand that Medicare beneficiaries who qualify for help paying their premiums through one of the four Medicare Savings Programs (MSPs)—the Qualified Medicare Beneficiary (QMB), Specified Low-Income Beneficiary (SLMB), Qualifying Individual (QI) or Qualified Working Disabled Individual (QDWI)—are not subject to estate recovery for those benefits.

Some states combine the application for full Medicaid with MSP benefits. You and/or your loved onefamily member can choose to apply for a Medicare Savings Program without applying for full Medicaid, and therefore not be subject to estate recovery. 

 

Where can I get help with estate recovery?

The rules around Medicaid estate recovery are complicated and vary by state. To get advice, you may want to reach out to:

• Your state or local Medicaid office
• Your local legal aid office serving low-income Americans
• An estate recovery program helpline or website in your state, if available

Also, every state has a State Health Insurance Assistance Program (SHIP) that can help people with Medicare apply for the Medicare Savings Programs. Visit the SHIP website or call 1-877-839-2675 to find your state’s program.