Under the SSI program's resource rules, funds in a financial-institution account, including savings, checking and certificates of deposit, are the owner's resource when the owner can use them for support and maintenance, and a transfer out of an account for less than fair market value can cause a penalty period under federal law. Federal law sets the framework, but each state runs its own program with its own rules, and a married couple's resources are measured together under separate spousal rules.
Most people facing this question are sitting with a parent's or spouse's bank statements and a nursing-home admission that came sooner than anyone planned. The worry is concrete: whether the savings a family built over decades will disqualify someone from help, whether a past gift to a grandchild will cause trouble, and what the husband or wife still at home gets to keep. This page walks through how long-term-care Medicaid treats bank accounts, from the first count through what can happen after death.
What a 'Countable Asset' Means Under Medicaid Rules
A countable asset, also called a resource, is anything the state adds up against its resource limit when it decides whether someone qualifies. Under the SSI program's resource rules, funds in a financial-institution account, including savings, checking and time deposits (also known as certificates of deposit), are an individual's resource if the individual owns the account and can use the funds for support and maintenance. How a state counts bank accounts for Medicaid depends on that state's current rules.
The opposite is an exempt asset, one the state leaves out. For people 65 and older or blind or disabled, Medicaid.gov explains that eligibility is generally determined using the income methodologies of the Supplemental Security Income (SSI) program, and the CMS eligibility policy page notes that the separate MAGI method used for most children, pregnant women, parents and adults does not allow for an asset or resource test. The SSI resource rules at 42 U.S.C. § 1382b(a) exclude items including the home, household goods, personal effects and an automobile within a value the Social Security Commissioner sets as reasonable, and burial space. Which assets a state excludes depends on that state's current rules.
Spend-down means lowering countable assets to the state's limit through allowable means before or during the application. The California Medi-Cal asset limits show how one state sets its own figures.
Asset Limits: What Federal Law Sets and What States Decide
The federal spousal-impoverishment rules in 42 U.S.C. § 1396r-5 protect part of a married couple's combined countable resources for the spouse still at home. That person is the community spouse, which 42 U.S.C. § 1396r-5(h)(2) defines as the spouse of an institutionalized spouse. The institutionalized spouse is, under § 1396r-5(h)(1), a person in a medical institution or nursing facility (or, at the state's option, certain people receiving home and community-based care) who is married to a spouse not in a medical institution or nursing facility; a person not likely to meet that requirement for at least 30 consecutive days is not included.
The amount of resources protected for the community spouse is the community spouse resource allowance, or CSRA (42 U.S.C. § 1396r-5(f)(2)). According to the CMCS Informational Bulletin of April 27, 2026, the minimum and maximum resource allowances are adjusted each January. The exact protected amount depends on the state's current rules within that framework.
A single applicant's countable-asset limit is a separate figure that depends on that state's current rules. For reference, the same bulletin lists the 2026 SSI resource standard, effective January 1, 2026, as $2,000 for an individual and $3,000 for a couple; that is the SSI figure, not any particular state's Medicaid limit.
How a state treats an account held jointly with a child, and how it treats an IRA or other retirement account, depends on that state's current rules.
How the Look-Back Period Applies to Bank Account Transfers
Under 42 U.S.C. § 1396p(c)(1)(B)(i), the look-back date is "36 months (or … in the case of any other disposal of assets made on or after February 8, 2006, 60 months)" before the key date. The look-back period is that window before an application in which the state reviews transfers made for less than fair market value. For any transfer made on or after February 8, 2006, the federal look-back is 60 months. The period and start date a particular state applies depend on that state's current rules.
The statute applies the look-back to institutionalized individuals and their spouses, and to people receiving care at home only at the state's option. Gifts from an account, payments to relatives for nothing in return, and transfers into certain trusts can all trigger a penalty period: a stretch of ineligibility for Medicaid-covered long-term care. Under § 1396p(c)(1)(E), its length for an institutionalized individual equals the total, cumulative uncompensated value of the assets transferred on or after the look-back date, divided by the average monthly cost to a private patient of nursing-facility services in the state (or, at the state's option, in the community where the person is institutionalized) at the time of application, and a state may not round down a fraction of a month.
Timing matters most. Under § 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 based on an approved application. So a gift made four years ago inside the look-back is penalized the same way as one made last month. Federal law lists exceptions; for example, a transfer to the person's spouse carries no transfer penalty (42 U.S.C. § 1396p(c)(2)(B)(i)). Whether any other exception fits depends on the facts and the state's rules. Medicaid crisis planning covers how this plays out when care is already needed.
How Medicaid Verifies Bank Account Balances
What a state's application asks about accounts, and which documents it requests to confirm balances, depends on that state's current rules. Because of the look-back, the federal rule is not limited to today's balance: a transfer for less than fair market value on or after the look-back date can cause a penalty period.
The methods a state uses, including any electronic checks with banks, how far back it requests statements in a given case, and what it asks for at renewal, depend on the state's program and the circumstances. Every account and every transfer belongs on the application.
Bank Accounts and the Community Spouse: What the At-Home Spouse Keeps
The federal statute measures a couple's resources "as of the beginning of the first continuous period of institutionalization (beginning on or after September 30, 1989)" of the institutionalized spouse (42 U.S.C. § 1396r-5(c)(1)(A)). This is often called the snapshot date: the date used to total the couple's countable resources and compute a spousal share equal to half. Either spouse may ask the state to assess and document that total once the state has relevant documentation of the couple's resources, and the state must include a notice of the right to a fair hearing with the assessment.
At application, § 1396r-5(c)(2) treats all resources held by either spouse or both as available to the institutionalized spouse, regardless of state community-property laws, except to the extent of the amount protected for the community spouse. That means accounts in the husband's name, the wife's name and joint accounts all go into the total. Under § 1396r-5(c)(4), during the continuous period in which the institutionalized spouse is in an institution and after the month in which that spouse is determined eligible, no resources of the community spouse are deemed available to the institutionalized spouse.
Income is a separate track. The minimum monthly maintenance needs allowance (MMMNA) is a floor of monthly income protected for the community spouse; the CMCS bulletin lists it at $2,705 for all states except Alaska and Hawaii, effective July 1, 2026. It concerns income, not bank balances. A state's exact CSRA figures and snapshot procedures depend on that state's current rules.
Spend-down uses countable money for allowable purposes to reach the state's limit; which uses qualify depends on that state's current rules. The Medicaid spend-down attorney page covers spend-down in more depth.
Trusts are treated by their terms. The CMS eligibility page states that when an individual, a spouse or anyone acting on the individual's behalf sets up a trust using at least some of the individual's funds, that trust can be considered available for eligibility. Whether a particular trust's assets count depends on its terms, when it was funded and state rules, and funding a trust inside the look-back can bring a penalty under § 1396p(c)(1). No trust protects assets in every case.
Annuities have a specific federal condition. Under § 1396p(c)(1)(F), buying an annuity is treated as a transfer for less than fair market value unless the state is named as remainder beneficiary in the first position for at least the total amount of medical assistance paid, or in the second position after the community spouse or a minor or disabled child and is named in the first position if that spouse or a representative of the child disposes of any remainder for less than fair market value. How a state then counts the annuity depends on its terms and state rules.
Whether any of these tools affects eligibility turns on the facts, the state and timing.
Estate Recovery and Bank Accounts After Death
Estate recovery is a state's claim, after a Medicaid recipient dies, for repayment of benefits from what remains in the estate. The CMS estate recovery page states that for individuals 55 or older, states are required to seek recovery for nursing facility services, home and community-based services, and related hospital and prescription drug services. The State Medicaid Manual transmittal on estate recoveries adds that, for permanently institutionalized individuals, including individuals of any age, whom the state determines cannot reasonably be expected to be discharged and return home, the state must seek adjustment or recovery, at a minimum, of amounts spent for services provided in a nursing facility, ICF/MR or other medical institution.
Federal law delays recovery, not cancels it, while a surviving spouse, a child under 21 or a blind or disabled child survives (42 U.S.C. § 1396p(b)(2)). CMS also states that states must have procedures to waive recovery for undue hardship.
An account that passes through probate is generally part of the estate. Whether a state can reach a joint account with survivorship rights or a payable-on-death account depends on how that state defines the estate. The home has its own rule: 42 U.S.C. § 1396p(f) bars long-term-care coverage above a home-equity limit unless a spouse, a child under 21 or a blind or disabled child lives there.
Requesting a Consultation
This page covered bank accounts and long-term-care Medicaid: how accounts are counted, the look-back, the spousal rules and estate recovery. It does not cover Medicare, private long-term-care insurance or veterans' benefits.
You can send a request for a consultation about your family's Medicaid and long-term-care options through Medicaid Asset Protection Group. Requests may be passed to attorneys, who decide for themselves whether to respond.
Frequently asked questions
What happens to your bank account when you go into a nursing home?
Under the SSI program's resource rules, funds in a financial-institution account are the owner's resource when the owner can use them for support and maintenance, and how a state counts the balance for Medicaid depends on that state's current rules. A transfer out of the account for less than fair market value inside the look-back can cause a penalty period. For a married couple, the spousal rules protect part of the combined resources for the spouse at home.
How often does Medicaid check your bank account?
How often and how deeply a state checks accounts depends on that state's current rules. Under federal law, a transfer for less than fair market value on or after the look-back date can cause a penalty period, and the look-back is 60 months for transfers made on or after February 8, 2006.
What is the asset limit for Medicaid eligibility?
A state's limit depends on that state's current rules, and limits change over time. For reference only, the CMCS Informational Bulletin of April 27, 2026 lists the SSI resource standard, effective January 1, 2026, as $2,000 for an individual and $3,000 for a couple; that is the SSI figure, not any particular state's Medicaid limit. Married couples fall under the federal spousal-impoverishment rules in 42 U.S.C. § 1396r-5.
Does Medicaid look at joint bank accounts?
Under the SSI program's resource rules, funds in a jointly held account are presumed to belong to the SSI claimant or recipient who is an account holder (in equal shares if there is more than one), and that person may submit evidence to rebut the presumption. How a state counts a joint account for Medicaid, including one shared with someone other than a spouse, depends on that state's current rules. For a married couple, 42 U.S.C. § 1396r-5(c)(2) treats resources held by either spouse or both as available at application, apart from the community spouse's protected amount, and a transfer out of the account for less than fair market value falls within the look-back.
Can I give money from my bank account to my children before applying for Medicaid?
A gift for less than fair market value within the look-back can cause a penalty period. Under 42 U.S.C. § 1396p(c)(1)(D)(ii), that penalty starts on the later of the transfer month and the date the person would otherwise be eligible and receiving institutional-level care. Federal law lists exceptions, and outcomes depend on the facts and state rules.
Does Medicaid check bank accounts after death?
Through estate recovery, a state can claim repayment from estate assets, which generally include accounts passing through probate. CMS states that for individuals age 55 or older, states are required to seek recovery for nursing facility services, home and community-based services, and related hospital and prescription drug services. Recovery is delayed while a surviving spouse, a child under 21 or a blind or disabled child survives, and its scope depends on the state.
Are retirement accounts like IRAs counted as assets for Medicaid?
How a state treats an IRA or similar retirement account depends on that state's current rules.
Reviewed by Russell E. Griffith, Esq.
California Trusts & Estates Attorney
California State Bar No. 120564
Licensed in California Since 1985
California Western School of Law
