How an “Intent to Return Home” Can Protect Your Home While Maintaining Medicaid Eligibility

Summary
To be financially eligible for Medicaid Long Term Care, you have to meet relatively low asset and income limits. If your home was counted against the asset limit, chances are good you’d be over the limit and ineligible for Medicaid. However, in most cases the primary residence will not be counted. This can be true even if you’re leaving the home empty and moving into a nursing home, as long as you file an intent to return home statement with your state Medicaid office.

 

What Is Intent to Return Home

An intent to return home statement is a documented assertion that even though you or your loved one is not living in your home, or you will be leaving it shortly, you still consider it your primary residence and you intend to live there again if your health allows. The statement’s primary purpose is to help you gain Medicaid eligibility by preventing your home from counting against the Medicaid asset limit. All Medicaid applicants must meet an asset limit (and an income limit) to be financially eligible, and the value of a home would put most people over their state’s asset limit.

Intent to return home statements can be useful when the Medicaid applicant is planning to move out of their primary residence and into a nursing home or any other location, like an assisted living facility or the home of a family member. There are also times when seniors may need to file intent to return statements after they have already been approved for Medicaid Long Term Care and have moved out of their primary residence.

Intent to return home statements can only apply to primary residences, and not vacation homes or any other property owned by the Medicaid applicant, which would all be considered countable assets. In general for Medicaid purposes, your primary residence is the home you were living in full time immediately before moving to a nursing home or some other location. Condominiums, mobile homes and house boats can all qualify as a primary residence. If you own a mobile home, you don’t have to own the property where it sits.

Some states require you to use their standard intent to return forms, but there is not a common form used for all 50 states.

 How to File: To see your state’s intent to return requirements and time limits, and the home equity interest limits, check the 50-state How To File Guide below.

 

When and How Intent to Return Home Is Relevant to Medicaid LTC Applications and Benefits

Intent to return home statements are primarily used by applicants for Nursing Home Medicaid, which is one of the three Medicaid Long Term Care programs. That’s because all Nursing Home Medicaid applicants are planning to move into a nursing home and will not be living in their primary residence. This means the primary residence could be counted as an asset, unless the applicant files an intent to return statement. To be clear, just filing an intent to return statement doesn’t guarantee your home will be exempt. The statement must meet your state’s requirements and be filed correctly.

Intent to return statements can also be used with the other two types of Medicaid Long Term Care, Home and Community Based Services (HCBS) Waivers and Aged, Blind and Disabled (ABD) Medicaid, but it is less common. In the majority of cases, homeowners applying for HCBS Waivers or ABD Medicaid plan on living in their home after they are approved for Medicaid, and if a Medicaid recipient lives in their home, it will not be counted as an asset. However, there are cases when a homeowner who is applying for, or already receiving, HCBS Waiver or ABD Medicaid benefits does not live in their own home, or is planning to move out if they receive benefits. They could be moving to an assisted living facility, adult group home or the private home of their adult child or sibling where they are planning to receive their HCBS Waiver or ABD Medicaid benefits. In these cases, the homeowner/Medicaid applicant or beneficiary will need to file an intent to return for the home to possibly be exempt from the asset limit.

Most states will accept an intent to return home statement even if it is not likely you will be able to return to your home. Although there are some states that require the intent to return statement includes proof (like a physician’s note) that the applicant’s health is likely to improve enough that they will actually be able to return home.

 Attention: Even if the individual is not likely to return to their primary residence, the intent to return home statement is still recognized in most states and maintains the non-countable status of the residence.

If certain qualifying family members (more on them below) live in the home, it will not be counted as an asset. In these cases, intent to return home statements would not be relevant because the home is already exempt.

It’s important to note that the home equity interest must be below your state’s limit in order for the home to be exempt. We’ll explain this more below, but the home equity interest is the portion of the home’s value that the applicant owns minus any outstanding mortgage / debt. In most states, the 2024 home equity interest limit is $713,000 or $1,071,000 (in states with high property values). So, if your home equity interest is above your state’s limit, intent to return statements will not be relevant because your home can not be exempt.

You should also know that some states limit the length of time the intent to return home can stay in effect. It can only last 6 months in Virginia, for example.

 

Intent to Return Home Exceptions

 

Qualifying Family Members

You will not need to file an intent to return home statement to prevent your home from counting against Medicaid’s asset limit if certain family members will still be living in the home after you have moved out. That’s because the home will be exempt from the asset limit if any of the following family members of the Medicaid applicant or beneficiary live there:

– Spouse
– Minor child (under 21 years old)
– Blind and disabled child (any age)
– Sibling with equity interest in the home who has lived there are least 1 year immediately prior to the Medicaid applicant’s relocation to the nursing home (known as the Sibling Exemption)
– Adult child who has lived in the home, and been serving as a caregiver, for at least 2 years prior to the Medicaid applicant’s relocation to the nursing home (known as the Child Caregiver Exemption)

The home will also be exempt from the asset limit if the Medicaid applicant or beneficiary is still living in the home.

 

Home Equity Interest Limits

Your home equity interest must be under your state’s home equity interest limit in order for the home to be exempt from the asset limit. However, it’s important to note this only applies for Nursing Home Medicaid and Home and Community Based Services (HCBS) Waivers. Home equity interest limits do not apply to Aged, Blind and Disabled (ABD) Medicaid applicants or beneficiaries.

To be clear, the home equity interest is not simply the value of the house. It is the value of the house that the applicant owns minus any outstanding debt or mortgage. For 2024, most states have set their home equity interest limit at either $713,000 or $1,071,000, for states with higher property values. There are some exceptions, like California, which does not have a home equity interest limit. To find the home equity interest in your state, consult the table below.

To sum up, intent to return home statements will be relevant for Nursing Home Medicaid, HCBS Waivers and ABD Medicaid applicants or beneficiaries if:
1) They are not living in their primary residence
2) They do not have a qualifying family member living in that residence
3) Their home equity interest in the primary residence is below the state’s home equity interest limit.

Intent to return home statements will not be relevant for Nursing Home Medicaid or HCBS Waivers applicants whose home equity interest is above their state’s limit.

 

Undue Hardship

The primary residence of a Medicaid beneficiary or applicant can also be exempt from some state’s asset limits if sale of the home would cause undue hardship to one of the home’s co-owners. Most often losing their housing would be the undue hardship for the co-owner, but if the primary residence also served as a place of business for a co-owner that could qualify the home for exemption. So, if there is a co-owner of your primary residence and sale of the home would cause that co-owner undue hardship in some manner, an intent to return home statement may be irrelevant for you because the home will already be exempt.

 

The Best Time to File Intent to Return Home

The simple rule of thumb is this: It’s never too early to file an intent to return home statement. Some states even ask if you intend to return to home on the Medicaid application. That being said, you can also file an intent to return statement after you have left your primary residence and moved to another location, as long as you have not put the home up for sale.

Even if there is a qualifying family member living in the home (such as a spouse) when the Medicaid recipient moves out, it’s still a good idea to file the intent to return statement as soon as possible. That way, if the qualifying family member leaves the home for any reason in the future, the home will remain an exempt asset without any possible penalty or gap in coverage. It’s also a good idea to create, sign and file the intent to return document while the Medicaid applicant / beneficiary is still mentally capable of making that kind of decision. Designated family members, most commonly with Power of Attorney, can make intent to return statements for their loved one, but the Power of Attorney or other designating documents need to created while the Medicaid applicant / beneficiary is still mentally capable.

 

What to Include

There is no standard intent to return home statement form used by all 50 states. Some states have specific forms that must be used for the statement to be valid. Many states, however, don’t have a standardized form for Medicaid applicants or beneficiaries to use.

In general, intent to return home statements need to include the name of the Medicaid applicant or beneficiary, the address of the home they intend to return to, the date, and the signature of the Medicaid applicant or beneficiary.

 Consequences: If your intent to return form is filed incorrectly, or not at all, you may be forced to sell your home to cover long term care costs and become eligible for Medicaid. If you’re already enrolled in Medicaid, you could lose your benefits.

 

Intent to Return Home Limitations

Filing an intent to return home form does not guarantee your home will be exempt from Medicaid’s asset limit. It also doesn’t protect your home from being sold after your death to reimburse the state for your long term care. Plus, some states limit how long intent to return can stay in effect, and what kind of health condition you must be in to file or maintain your intent to return statement.

 

Medicaid Estate Recovery Program

While intent to return home statements can protect your primary residence from the asset limit being when it comes to qualifying for Medicaid Long Term Care, they will not protect the home from Medicaid Estate Recovery.

Every state has a Medicaid Estate Recovery Program (MERP) that is required by law to try and collect reimbursement for the cost of care after a Medicaid beneficiary passes away. The reimbursement comes from the beneficiary’s estate, and the most prominent asset in these estates is usually the home.

In order to collect reimbursement through the home, states can sometimes put a lien on a Medicaid recipient’s home while they are still alive. A lien prevents the recipient from selling or transferring the home in an attempt to stop Medicaid from trying to collect after their death. Medicaid cannot put a lien on a recipient’s home if any qualifying family members still live their – the Medicaid recipient’s spouse, sibling with partial ownership, adult child caregiver or minor, blind or disabled child lives there.

Since MERPs will force the sale of your home after your death, you might be tempted to sell your home now and use the proceeds to pay for your long term care. In most cases, however, the smart financial decision would be to file an intent to return home statement and allow the MERP to collect. This is because the private rate you would pay for long term care with those proceeds would be more expensive than the Medicaid rate. And that private rate would use the house sale proceeds faster than the Medicaid rate, which means less money to leave to your heirs, if there is any leftover after paying for the long term care.

There are ways to protect the home from Medicaid Estate Recovery, like Medicaid Asset Protection Trusts and Ladybird Deeds, although we recommend consulting with a Medicaid planning professional before trying to use any of these strategies on your own. There are also times when the state will not attempt to collect reimbursement, like when the deceased recipient’s spouse is still alive, regardless of where they are living, or if the deceased has a minor, blind or disabled child, regardless of where they are living. Many states also have a one-year statute of limitations on estate recovery.

 

Time and Health limits

Some states set a limit on the amount of time that a Medicaid Long Term Care recipient’s intent to return home statement is valid. Virginia and New Hampshire, for example, only allow the intent to return home exemption last a maximum of six months. This means that after six months in a nursing home Virginia and New Hampshire residents are considered to be permanently living in the nursing home, so their intent to return home exemption will end at that time and their home will be considered an asset. Some states require intent to return to be renewed every time your Medicaid benefits are renewed, or at other regular intervals.

Some states, like South Dakota, allow doctors and nursing home staff to overrule an intent to return home document. This means if the medical professional believes there is no possibility the Medicaid Long Term Care recipient will be able to leave the nursing home, the intent to return home will be ruled invalid and the home will be counted as an asset.

If a home goes from exempt to countable and puts the Medicaid recipient over the asset limit, there are ways they can remain eligible and still receive Medicaid benefits. For example, they could sell the home and “Spend Down” the proceeds on Medicaid-approved items and services, such as paying in advance for nursing home care. However, strategies like this are complicated, and we recommend consulting with a Medicaid planning professional before attempting to do this on your own.

 

Intent to Return Variances by State

While many states do share rules governing intent to return home policies, there are differences. The table below lists all 50 states and the District of Columbia and indicates how they handle some of the key aspects of intent to return home statements.

– “Length limit” refers to how long the state allows intent to return home statements to be valid.
– “Physician note stating probable return required” means that intent to return home statements in these states must include a physician’s note expressing that it is reasonable to expect the Medicaid applicant / beneficiary’s health to improve enough they can return home.
– “Probable return required” means the individual filing the intent to return statement must be likely to actually return home for the statement to be valid. Most states do not require this.
– “State-specific form” means the state has an official form its residents must use to make an intent to return home statement.

Medicaid “Intent to Return Home” Statement Variables by State – Updated Jan. 2024
State Length limit Physician note required Probable return required State specific form How to file intent to return 2024 Home equity interest limit
Alabama No No No Yes. Form 214: Statement of Intent to Return Home

 

To access Form 214, click on this link. Complete the form and submit with your application or to your Medicaid case worker. $713,000
Alaska Check with state Medicaid office No No Yes. Alaska’s “Statement Regarding Principal Place of Residence” To access Alaska’s “Statement Regarding Principal Place of Residence,” click on this link. Complete the form and submit with your application or to your Medicaid case worker.

 

$713,000
Arizona No No No No Access an Intent to Return Statement for Arizona as an HTML page or as a Downloadable PDF. Complete form and submit with your application or to your Medicaid case worker. The statement will be accepted as long as it’s not self-contradictory. $713,000
Arkansas No, but the Intent to Return home must be documented at 12-month intervals. No No No Access an Intent to Return Statement for Arkansas as an HTML page or as a Downloadable PDF. Complete form and submit with your application or to your Medicaid case worker. The statement will be accepted as long as it’s not self-contradictory. $713,000
California No No No No Check “yes” on your Medi-Cal application when asked if you wish to return home. If you have already applied and would like to submit an Intent to Return form to your Medi-Cal case worker, you can access an Intent to Return Statement for California as an HTML page or as a Downloadable PDF. None
Colorado No No No No Access an Intent to Return Statement for Colorado as an HTML page or as a Downloadable PDF. Complete form and submit with your application or to your Medicaid case worker. $1,071,000
Connecticut No, but it must be renewed every 6 months along with a re-evaluation of your medical condition and likelihood of returning. Yes Yes No The Connecticut Department of Social Services will evaluate you to see if you are likely to return home when you apply for Medicaid, and it will repeat the evaluation every 6 months. In addition, you will need to submit an Intent to Return statement. To access an Intent to Return statement form for Connecticut, click for HTML page or as a Downloadable PDF. $1,071,000
Delaware No No No Yes To access Delaware’s form, click here. The Medicaid client must sign or mark the form. In no case can the family sign for them. $713,000
District of Columbia No No No No Click here for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Washington, D.C. Complete form and submit with your application or to your Medicaid case worker. $1,071,000
Florida No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Florida. Complete form and submit with your application or to your Medicaid case worker. Florida residents may also state an intent to return to a home in another state and that home can be exempt from the asset limit. $713,000
Georgia No No No No Click here for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Georgia. Complete form and submit with your application or to your Medicaid case worker. $713,000
Hawaii No, but the intent to return must be renewed every year. No, but if there is no plan to be discharged from the nursing home (or any other setting) after 6 months, the intent to return goes out of effect. Yes. There must be a plan to be discharged from the nursing home (or any other setting) after 6 months or the intent to return goes out of effect. Yes. DHS 1167. To access DHS 1167, click on this link. Complete the form and submit with your application or to your Medicaid case worker. $1,071,000
Idaho No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Idaho.  Complete form and submit with your application or to your Medicaid case worker. $750,000
Illinois No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Illinois. Complete form and submit with your application or to your Medicaid case worker. $713,000
Indiana No Yes, if the Medicaid recipient’s health condition suggests they will not return. Yes No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Indiana. Complete form and submit with your application or to your Medicaid case worker. $713,000
Iowa No No, as long as the intent to return does not contradict another statement in the Medicaid recipient’s record. Yes No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Iowa. Complete form and submit with your application or to your Medicaid case worker. $713,000
Kansas No No No Yes. Statement of Intent to Return Home. To access Kansas’s Statement of Intent to Return home, click here. Complete the form and submit it with your Medicaid application or to your case worker. $713,000
Kentucky No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Kentucky. Complete form and submit with your application or to your Medicaid case worker. $713,000
Louisiana No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Louisiana.  Complete form and submit with your application or to your Medicaid case worker. $713,000
Maine No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Maine. Complete form and submit with your application or to your Medicaid case worker. $750,000
Maryland No No No Yes. DHMH Form 4255: Statement of Intent to Return Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Maryland. Complete form and submit with your application or to your Medicaid case worker. Maryland residents must submit this form even if they have a spouse who is still living in the home. $713,000
Massachusetts Check with your state Medicaid offices No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Massachusetts. Complete form and submit with your application or to your Medicaid case worker. $1,071,000
Michigan No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Michigan. Complete form and submit with your application or to your Medicaid case worker. $713,000
Minnesota No No, unless the Medicaid client’s nursing home stay is expected to be longer than 180 days, or their health conditions suggest they may not be able to return home. Yes No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Minnesota. Complete form and submit with your application or to your Medicaid case worker. $713,000
Mississippi No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Mississippi. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Missouri No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Missouri. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Montana No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Montana. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Nebraska 6 months. After 6 months the Medicaid beneficiary will be given reasonable time to sell the home. No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Nebraska. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Nevada No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Nevada. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
New Hampshire 6 months. After 6 months the home must be listed at fair market value, or rented to produce income. No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for New Hampshire. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
New Jersey No Yes Yes No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for New Jersey. Complete the form and submit it with your application or to your Medicaid case worker. $1,071,000
New Mexico No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for New Mexico. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
New York No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for New York. Complete the form and submit it with your application or to your Medicaid case worker. $1,071,000
North Carolina No No No Yes, dma-5159: Statement of Intent to Return Home To access North Carolina’s dma-5159: Statement of Intent to Return home, click here. Complete the form and submit it with your Medicaid application or to your case worker. $713,000
North Dakota 6 months per period of institutionalization No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for North Dakota. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Ohio No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Ohio. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Oklahoma 12 months. After 12 months medical evidence must be provided to show feasibility of return within 90 days. Yes, to provide evidence of a feasible return within 90 days after a 12-month absence. Yes, after 12 months. Yes, DHS Form 08MA010E, Acknowledgment of Temporary Absence/Home Property Policy To access Oklahoma’s DHS Form 08MA010E, Acknowledgment of Temporary Absence/Home Property Policy, click here. Complete the form and submit it with your Medicaid application or to your case worker. $713,000
Oregon No Yes Yes No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Oregon. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Pennsylvania No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Pennsylvania. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
Rhode Island No, but the intent to return statement must be resubmitted with every Medicaid renewal. No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Rhode Island. Complete the form and submit it with your application or to your Medicaid case worker. $713,000
South Carolina No No No Yes, DHHS Form 1277 ME To access South Carolina’s DHHS Form 1277 ME, click here. Complete the form and submit it with your Medicaid application or to your case worker. $713,000
South Dakota No, but intent to return must be renewed every 12 months. Yes Yes No, but there is a form for the physician to complete. Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for South Dakota. And click here to access the form your physician must complete. Complete both forms and submit them with your application or to your Medicaid case worker. $713,000
Tennessee No, but the intent to return must be confirmed with every renewal. No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Tennessee. Complete form and submit with your application or to your Medicaid case worker. Tennessee residents may also state an intent to return to a home in another state and that home can be exempt from the asset limit. $713,000
Texas No No No Yes, Form H1245 Statement of Intent to Return Home To access Texas’s Form H1245 Statement of Intent to Return Home, click here. Complete the form and submit it with your Medicaid application or to your case worker. $713,000
Utah No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Utah. Complete form and submit with your application or to your Medicaid case worker. $713,000
Vermont No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Vermont. Complete form and submit with your application or to your Medicaid case worker. $713,000
Virginia 6 months No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Virginia. Complete form and submit with your application or to your Medicaid case worker. $713,000
Washington No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Washington. Complete form and submit with your application or to your Medicaid case worker. $1,071,000
West Virginia Information currently unavailable.
Wisconsin No No No No Click for a printable Intent to Return Statement webpage or a downloadable Intent to Return Statement PDF for Wisconsin. Complete form and submit with your application or to your Medicaid case worker. $750,000
Wyoming No, but the intent to return must be re-stated annually No No Yes, DHCF 302 To access Wyoming’s form DHCF 302, click here. Complete the form and submit it with your Medicaid application or to your case worker. $713,000