How Gifts Can Affect Medicaid Eligibility

We’ve all heard that it’s better to give than to receive.

But if you think you might someday want to apply for Medicaid long-term care benefits, you need to be careful because giving away money or property can interfere with your eligibility. 

What Is Medicaid?

Medicaid is a public benefits program that provides health insurance for low-income individuals, including seniors and individuals with disabilities. To qualify for Medicaid, an individual's total assets and income must be below a certain threshold. Generally, most states set this threshold at $2,000 in what are known as "countable" assets.

Will I Have to Pay a Transfer Penalty?

Under federal Medicaid law, if you transfer certain assets within five years before applying for Medicaid, you will be ineligible for a period of time (called a transfer penalty), depending on how much money you transferred. Even small transfers can affect eligibility. While federal law allows individuals to gift up to $17,000 a year (in 2023) without having to pay a gift tax, Medicaid law still treats that gift as a transfer.

Any transfer that you make, however innocent, will come under scrutiny. For example, Medicaid does not have an exception for gifts to charities. If you give money to a charity, it could affect your Medicaid eligibility down the road.

Similarly, gifts for holidays, weddings, birthdays, and graduations can all cause a transfer penalty. If you buy something for a friend or relative, this could also result in a transfer penalty.

Spending a great deal of cash all at once or over time could prompt the state to request documentation showing how the money was spent. If you don't have documentation showing that you received fair market value in return for a transferred asset, you could be subject to a transfer penalty.

What Transfers Are Exempt?

While most transfers are penalized, certain transfers are exempt from this penalty. Even after entering a nursing home, you may transfer any asset to the following individuals without having to wait out a period of Medicaid ineligibility:

• your spouse

• a trust for the sole benefit of your child who is blind or permanently disabled

• a trust for the sole benefit of anyone under age 65 who is permanently disabled

In addition, special exceptions apply to the transfer of a home. The Medicaid applicant's home may be transferred to the individuals above, and the applicant also may freely transfer their home to the following individuals without incurring a transfer penalty:

• A child who is under age 21
• A child who is blind or disabled (the house does not have to be in a trust)
• A sibling who has lived in the home during the year preceding the applicant's institutionalization and who already holds an equity interest in the home
• A "caretaker child," who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant's institutionalization and who during that period provided care that allowed the applicant to avoid a nursing home stay.

Before giving away assets or property, check with your attorney to ensure that it won't affect your Medicaid eligibility. Find a qualified elder law attorney near you.

Learn more about Medicaid’s transfer rules, or find additional information on gift tax rules.

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