Countable Assets for Medicaid: What They Are and How They Affect Eligibility

When a parent or spouse needs nursing-home care, Medicaid looks at what they own and sorts it into two groups. Countable assets, such as bank accounts, investments and a second home, count toward the state's asset limit. Exempt assets, such as the home under certain conditions, one vehicle and personal belongings, do not. Each state applies its own limit and rules.

Most people facing this question are sitting with a stack of bank statements and a nursing-home admission that came sooner than anyone planned. An adult child may be trying to work out whether a mother's savings, her IRA or the house will stand in the way of Medicaid paying for her care. A husband or wife may be asking something harder: what will be left for the spouse who stays at home. This page explains how Medicaid sorts assets for long-term care, what a spouse at home keeps, how gifts are reviewed, and what happens after death.

What a Countable Asset Is Under Medicaid Rules

A countable asset is anything the applicant owns, or has the right to turn into cash, that Medicaid adds up and measures against the asset limit. An exempt asset, also called a non-countable or excluded asset, is one Medicaid sets aside and does not add in. Some exempt assets are left out whatever their value; others are left out only up to a limit or under conditions.

That sorting decides eligibility. If countable assets sit above the limit, the state agency generally denies long-term-care coverage until they come down. The state Medicaid agency makes that call when it reviews the application, based on what the applicant owns at the time it looks.

There is no single national limit. Medicaid, as the Medicaid.gov eligibility page puts it, "is a joint federal and state program." Federal law sets the framework, and each state runs its own program with its own asset limit and its own list of how particular assets are treated. Congress even created a commission under 42 U.S.C. § 1396 to review "Medicaid and CHIP eligibility policies, including a determination of the degree to which Federal and State policies provide health care coverage to needy populations".

The same page notes that the newer income method used for most adults "does not allow for an asset or resource test." Long-term care for older and disabled applicants is different: assets are generally counted.

Common Examples of Countable Assets

These are the asset types state agencies commonly count. The list is illustrative, not complete, and the applicant's state rules decide what counts in a given case.

• Cash and bank accounts, including checking, savings and money market accounts.
• Certificates of deposit (CDs).
• Stocks, bonds, mutual funds and brokerage accounts.
• A second or vacation home, or other real estate beyond the primary residence.
• Additional vehicles beyond the one automobile the SSI regulations exclude, counted at their equity value.
• Life insurance with a cash surrender value. Under the SSI regulations as in force in October 2026, a policy counts to the extent of its cash surrender value, unless the total face value of all life insurance policies on the person is $1,500 or less. State rules can differ.
• Retirement accounts. How a state treats IRAs and 401(k)s, whether as a countable asset or in some other way, depends on that state's current rules.
• Trusts. A trust the person can revoke, or whose principal they can reach, is generally treated as available to them. An irrevocable trust is generally treated as available to the extent payments could be made from it to or for the person, under the federal trust rules in 42 U.S.C. § 1396p(d). Under certain conditions, as the Medicaid.gov estate recovery page states, money left in a trust after the enrollee dies may be used to reimburse Medicaid.

Assets Medicaid Typically Does Not Count

Federal law's list of resources excluded for Supplemental Security Income, 42 U.S.C. § 1382b, shows the main categories. It excludes "the home (including the land that appertains thereto)"; "household goods, personal effects, and an automobile, to the extent that their total value does not exceed such amount as the Commissioner of Social Security determines to be reasonable"; burial space and certain burial agreements "subject to such limits as to size or value"; and property "so essential to the means of self-support" as to warrant exclusion, including property "used in a trade or business." Each state's Medicaid program decides how these categories apply to long-term care.

• The primary home. It is generally exempt while the applicant intends to return or while a spouse or dependent relative lives there. It is not excluded whatever its value: 42 U.S.C. § 1396p(f) bars long-term-care coverage when home equity is above a set limit, unless a spouse, a child under 21 or a blind or disabled child lives in the home.
• One automobile used for transportation for the person or a household member, which the SSI regulations exclude regardless of value. State rules can differ.
• Household goods and personal effects. The SSI regulations do not count furniture, appliances or personal jewelry such as wedding and engagement rings, but they do count items held for their value or as an investment.
• Burial spaces and agreements to purchase them, and, under the SSI regulations as in force in October 2026, up to $1,500 each in funds set aside for the burial expenses of the person and a spouse, kept separate and clearly designated for burial.
• Term life insurance, which has no cash surrender value to count, and policies whose total face value on the person is $1,500 or less, under the SSI regulations.
• Business property used in a trade or business that supports the applicant, subject to state rules.

Every exemption has conditions. A state can treat an asset as exempt in one setting and countable in another.

How Asset Limits Work for a Married Couple: Community Spouse Rules

Federal spousal-impoverishment law, 42 U.S.C. § 1396r-5, protects the spouse who stays home. The community spouse is the husband or wife who remains in the community while the other spouse, the institutionalized spouse, applies for Medicaid long-term-care coverage. Per the Medicaid.gov spousal impoverishment page, "a certain amount of the couple's combined resources is protected for the spouse living in the community."

That protected amount is the community spouse resource allowance (CSRA): the share of the couple's combined countable assets the community spouse may keep. The statute defines it as the greatest of "$12,000 (subject to adjustment under subsection (g)), or, if greater... an amount specified under the State plan," "the lesser of (I) the spousal share computed under subsection (c)(1), or (II) $60,000 (subject to adjustment...)," an amount set at a fair hearing, or an amount transferred under a court order, to the extent it exceeds the community spouse's own resources. Those base figures are adjusted. The community spouse minimum and maximum resource allowances "are adjusted each January," according to the CMS April 27, 2026 bulletin, and under 42 U.S.C. § 1396r-5(f)(2) a state plan may specify a higher minimum, not exceeding the maximum.

The spousal share is calculated from the couple's combined countable assets totaled as of a point in time the statute sets, often called the snapshot. A transfer to a spouse carries no transfer penalty under 42 U.S.C. § 1396p(c)(2)(B)(i).

Income has its own counterpart. The minimum monthly maintenance needs allowance (MMMNA) is the monthly income level the community spouse can be brought up to, using part of the institutionalized spouse's income when the community spouse's own income falls short. Federally it is $2,705.00 in all states except Alaska ($3,381.25) and Hawaii ($3,111.25), effective July 1, 2026, per the CMS bulletin. A state's own figure applies from the date that state sets.

The Look-Back Period and How Asset Transfers Affect Eligibility

The look-back period is the stretch of time before the application during which the agency reviews gifts and other transfers made for less than fair market value. Federally it is 60 months for any transfer made on or after February 8, 2006, under 42 U.S.C. § 1396p(c)(1)(B)(i). States do not all use the same look-back. California's look-back period, and the date it started, are the ones the California Department of Health Care Services states, and they depend on California's current rules.

A penalty period is a stretch of time during which Medicaid will not pay for long-term care, generally figured by dividing the value transferred by the average monthly cost to a private patient of nursing-facility care in the state. Under 42 U.S.C. § 1396p(c)(1)(D)(ii), the penalty starts on the later of the month of the transfer and the date the person is eligible and would otherwise be receiving institutional-level care. A gift made four years ago and a gift made last month are penalized the same way, if both fall inside the look-back.

Not every transfer is penalized. 42 U.S.C. § 1396p(c)(2) lists exceptions, including transfers to the person's spouse. 42 U.S.C. § 1396r-5(f)(3) adds that the penalty rules "shall not apply" to resources transferred under a court support order for the community spouse or a family member. Whether another exception applies depends on who received the asset and the facts.

The Medicaid crisis planning page covers how these rules play out once care has already begun.

How Asset Limits Vary by State

Each state runs its own program within the federal framework, so its asset limit for a single applicant is the one its Medicaid agency publishes. For reference, the federal SSI resource standard, effective January 1, 2026, is $2,000 for an individual and $3,000 for a couple, per the CMS bulletin. A state's long-term-care Medicaid limit is its own figure and may differ.

The CSRA also varies, since states may choose a figure within the federal floor and ceiling. How a state treats retirement accounts, burial funds, life insurance and vehicles depends on that state's current rules.

Spousal refusal is where a community spouse declines to make assets available; whether a state allows it depends on that state's current rules.

State pages on this site show the variation. The Florida Medicaid planning page sets out that state's figures, and the California Medi-Cal asset limits page covers Medi-Cal's. In California, "share of cost" concerns monthly income, which is separate from bringing assets down to the asset limit. The current figure for any state is the one its Medicaid agency publishes, with the date it applies from.

Estate Recovery: What Happens to Assets After Death

Estate recovery is the process a state Medicaid agency uses to seek repayment, from a beneficiary's estate after death, for benefits it paid. Under 42 U.S.C. § 1396p(b)(1), the state "shall seek adjustment or recovery" for a person who "was 55 years of age or older when the individual received such medical assistance," for "nursing facility services, home and community-based services, and related hospital and prescription drug services," and at the state's option for other services, except Medicare cost-sharing paid for Medicare Savings Program beneficiaries. The statute also requires recovery for certain permanently institutionalized individuals.

Federal law delays recovery, never cancels it, while a surviving spouse, a child under 21 or a blind or disabled child survives, under 42 U.S.C. § 1396p(b)(2). The CMS estate recovery page adds that states "are also required to establish procedures for waiving estate recovery when recovery would cause an undue hardship." States may also place a lien on the real property of a permanently institutionalized enrollee during life, but not on the home while a spouse, a child under 21, a blind or disabled child, or a sibling with an equity interest who lived there for at least a year before the enrollee's admission lawfully lives there; the lien dissolves when the enrollee is discharged and returns home.

What a state recovers from depends on its rules. In California, for members who died on or after January 1, 2017, recovery is limited to estate assets subject to probate, as the California Department of Health Care Services states. An asset exempt during life, such as the home, may be reachable after death, depending on the state.

If You'd Like to Talk Through Your Situation

Whether an asset counts usually turns on details a general page cannot settle: how an account is titled, what kind of retirement plan or life insurance policy it is, which spouse owns what, when any gifts were made, and which state's rules apply. This page does not cover Medicare, private long-term-care insurance or veterans' benefits, and the Medicaid spend-down and Medicaid planning attorney pages explain related questions in more depth.

You can request a consultation about your family's Medicaid and long-term-care options through Medicaid Asset Protection Group, which is not a law firm; a request may be passed to attorneys who decide for themselves whether to respond.