How Joint Home Ownership Impacts Medicaid Long-Term Care Eligibility

Summary
How joint home ownership affects Medicaid Long Term Care Eligibility depends on how the joint ownership was established. If the co-owners buy the home together, their shares in the property will be treated like all homes are treated under Medicaid rules, which are discussed below. If the co-owner is added after the home has already been purchased, however, the Medicaid eligibility of the person who purchased the home in the first place will be in jeopardy for adding the new co-owner. This can be an issue for elderly parents who want to add an adult child as a co-owner, but there are other options for families in this situation that can help the senior qualify for Medicaid while maximizing their home as an asset for themselves and their family.

Why Adding a Home Co-Owner Can Jeopardize Medicaid Eligibility

To qualify for Medicaid Long Term Care, applicants need to meet two financial requirements – and asset limit and an income limit. In most states in 2025, the individual asset limit is $2,000. If homes counted toward that limit, homeowners would not be able to qualify, but the home is exempt from the limit in many cases.

However, even if the home is exempt, Medicaid still considers it an asset. This is important when it comes to understanding how home co-ownership impacts eligibility.

Medicaid Long Term Care applicants aren’t allowed to simply give away their assets in order to meet their asset limit and qualify for Medicaid. To make sure they don’t, states use the Look-Back Period. In most states, the Look-Back Period is five years long, which means the state will “look back” into the applicant’s financial history for the five years prior to their application date to make sure they have not given away any assets or sold them at less than fair market value.

Re-titling a home to add a co-owner with joint ownership is a violation of the Look-Back Period because it’s like giving away part of the home, which is an asset. Medicaid Long Term Care applicants who have violated the Look-Back Period will have their application denied and they will be penalized with a period of ineligibility that could last months or years. It should be noted that the Look-Back Period only applies to Nursing Home Medicaid and Home and Community Based Services (HCBS) Waivers, it does not apply to Aged, Blind and Disabled (ABD) Medicaid.

Adding a co-owner by re-titling a home is a common practice in estate planning because it can ensure the home passes directly to the new co-owner. However, as we just explained, it’s not a good idea for homeowners who might need Medicaid Long Term Care. There is one exception, which we will discuss next.

Adding a Spouse as a Co-Owner

Re-titling a home to add a spouse as a co-owner would not jeopardize Medicaid eligibility because it does not violate the Look-Back Period. Medicaid considers all assets of married couples to be jointly owned, so adding a spouse as a co-owner would not be considered giving away assets. Most married couples will buy their home together, so both spouses’ names are on the deed to begin with, but in some cases one of the spouses may have owned the property prior to the marriage, or perhaps bought the property on their own.

Some married couples will use a Tenancy by the Entirety to establish joint ownership of a property. This type of agreement is only for married couples and establishes each spouse as owning the entire property as opposed to just a portion. It also automatically transfers full ownership to the surviving spouse after the death of a spouse (avoiding probate), provides some protection from creditors in certain states, and mandates that neither spouse can sell, mortgage or transfer the property without the consent of the other.

Maintaining or establishing joint home ownership is a reasonable option for married couples who are both applying for or receiving Medicaid Long Term Care. When only one spouse is enrolled in Medicaid, however, many married homeowners choose a different path. They often put the home in the name of the non-Medicaid spouse, often called the community spouse, after the other spouse has enrolled in their Medicaid program. This is because the assets of the community spouse are not counted during the annual Medicaid Renewal of the beneficiary spouse. The annual Medicaid Renewal is what states use to make sure Medicaid beneficiaries continue to meet their financial and functional eligibility requirements after they’ve enrolled.

Types of Joint Home Ownership

Two of the most common types of joint home ownership agreements are:

Joint Tenants with Rights of Survivorship, which splits the property equally among the co-owners and mandates that upon the death of one of the co-owners their share in the property is automatically given to the remaining co-owner(s), and divided equally if there are multiple co-owners.

Tenants in Common, which does not necessarily split the property evenly among co-owners, and upon the death of a co-owner their interest in the property will be passed on according to their will and the state probate laws, as opposed to being automatically given to the remaining co-owner(s) like a Joint Tenants with Rights of Survivorship agreement.

Buying a Home with an Elderly Parent

Homeowners who want to add a co-owner (other than their spouse) but also want to apply for Medicaid Long Term Care do have another option. The homeowner could sell their current home and buy a new home with the co-owner and establish joint ownership from the start. This would not be a Look-Back violation because the senior and the co-owner would be buying the home together. However, some states may consider it a violation if the senior pays for more than their share of the home (more than half if there are two owners, more than a third if there are three owners, etc.). To understand the laws in your state, we recommend consulting with a professional.

This might be a good option for a senior homeowner who wants to co-own with an adult child, another family member or even a friend who will also serve as a caregiver. It would allow the senior to stay at home and age in place for as long as possible. During this time, it’s important for the senior and the co-owner(s) to evenly share home expenses, such as mortgage, property tax, maintenance, and keep detailed records of these transactions. If the senior pays more than their share it could be viewed as a Look-Back violation.

When the senior is ready to apply for Medicaid, their portion of the home would be exempt, as long as it was under the state’s home equity interest limit. Click here to learn more about home equity interest and find the limit in your state. The senior could apply for HCBS Waivers to receive long-term care services and supports in the home so they could continue to live there. Or they could apply for Nursing Home Medicaid and when they relocate to the facility, the co-owner would stay in the home and take care of maintenance and paying the bills, which can be an issue for senior homeowners who move into a care facility but don’t immediately sell their home.

When a senior in this situation passes away, the home could pass directly to the co-owner, avoiding probate, if a Joint Tenant with a Rights of Survivorship was used to establish joint ownership when the home was purchased. This can help avoid Medicaid Estate Recovery in some states, which we will discuss next.

How Joint Ownership Can Protect a Home from Medicaid Estate Recovery

After the death of a Medicaid Long Term Care beneficiary, states are legally obligated to try and collect reimbursement from the deceased’s estate for the long-term care expenses it paid for the beneficiary during their lifetime. This process is known as Medicaid Estate Recovery. Some states, known as “probate-only” states will only attempt recovery via assets that go through the probate process. Other states, known as expansion states, will attempt recovery via assets outside of probate.

For Medicaid beneficiaries who were homeowners, the home is usually the most valuable asset in their estate. If that’s the case, the home may need to be sold in order to reimburse the state for Medicaid Long Term Care expenses.

However, if there is a joint ownership agreement in place where the home passes directly from one co-owner to another while avoiding probate (like a Joint Tenant with a Rights of Survivorship), the home will be safe from Medicaid Estate Recovery if the beneficiary lived in a probate-only state. If the beneficiary lived in an expansion state, the state could still try to collect via the home and force a sale. If the joint ownership agreement does not mandate the home pass directly from one co-owner to another (like a Tenant in Common), the home will have to go through probate and will be subject to Medicaid Estate Recovery.

So, anyone considering buying a home with an elderly loved one as described above should know if their state is probate-only or expansion. Click here to find out the Medicaid Estate Recovery details in your state.

Other Options for Joint Home Ownership

Whether the co-owner is an adult child, a sibling, another relative or simply a friend, the rules surrounding joint ownership that are described above remain the same: Re-titling a home to add any of those people as a co-owner would be a Look-Back violation for the senior homeowner, but any of them could buy a home with a senior and establish joint ownership without jeopardizing Medicaid eligibility, all as described above.

However, adult children and siblings do have other options when it comes to sharing a home with a potential Medicaid applicant and transferring ownership without jeopardizing their eligibility.

Child Caregiver Exemption
The Child Caregiver Exemption allows a Medicaid applicant to transfer their home to a qualified adult child without violating the Look-Back Period. The adult child is qualified if they have lived in the home for at least two years prior to their parent applying for Medicaid, and during that time they provided care that delayed their parent’s need for Medicaid-funded long-term care. The adult child must also be biological or adopted, this exemption does not apply to step or foster children. The home, as is the case with all of the rules discussed on this page, can be a single-family house, condo, multi-unit property, mobile home or houseboat, but whatever form it takes the property must be the Medicaid applicant’s primary home, it can not be a second or vacation home.

Sibling Exemption
Siblings can use the Sibling Exemption, which allows a Medicaid applicant to transfer their home to a qualified sibling without violating the Look-Back Period. Siblings are qualified if they have an equity interest in the home (meaning they are co-owners) and have lived there for at least one year prior to their sibling receiving Medicaid Long Term Care. The siblings must be biological or adopted, step and foster siblings can not qualify for this exemption.