Long-term care Medicaid reviews five years of your financial history. The Deficit Reduction Act of 2005 set the look-back period at 60 months before the application date, and transfers for less than fair market value inside that window delay eligibility.[5]
A life estate deed is that kind of transfer. You kept the life estate; you gave away the remainder. Washington's Medicaid agency states the rule: "If the remainder interest was transferred for less than fair market value, the medicaid agency or the agency's designee will evaluate the transaction as an asset transfer."[4]
The size of the transfer depends on your age. Washington and Georgia both value the two interests the same way: multiply the home's fair market value by age factors from the Social Security Administration's life estate tables.[2][4] In Georgia's table, a 70-year-old's remainder interest is 39.478 percent of the property's value.[2]
Sign a life estate deed on a $300,000 house at 70 and you've made a $118,434 gift. Apply for nursing home Medicaid within five years and that figure converts into months of care Medicaid won't pay for.
The rule also covers the reverse arrangement: paying money for a life estate in someone else's home, usually a child's. Federal law counts the full purchase price as a transfer unless you actually live in that home for at least one year after the purchase.[6] The rule exists because people were buying life estates in their children's homes with no intention of ever living there.[5]
Passing the five-year mark settles eligibility. It doesn't always settle recovery. States must recover what Medicaid spent on long-term care from the estates of recipients 55 and older, though never while a spouse, a child under 21, or a blind or disabled child survives.[7] Federal law then lets each state decide how big "estate" is: the probate estate only, or any property the person held an interest in at death, including assets conveyed through "joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement."[6]
In a probate-only state, a life estate that ends at death usually leaves Medicaid nothing to claim. In an expanded-recovery state, it can. Which kind of state you're in is a question for a licensed elder law attorney, and our state guides cover the rest of what changes with your state.
One more piece while you're alive: the home you live in is usually excluded from Medicaid's resource count, and Washington treats a life estate the same way, subject to home equity limits.[4]