What assets are counted vs. not counted by Medicaid
Medicaid divides your assets into countable and exempt. Countable assets must be spent down before benefits begin; exempt assets generally don’t affect eligibility. The trick is knowing exactly where the line falls.
These are the questions that matter most when you’re thinking about Medicaid eligibility.
What does Medicaid count as your assets?
Most assets owned in your individual name. Nine quick questions about what you own. Brent reads your answer back to you at the end.
A 60-second guided check. See which of your assets would face Medicaid spend-down.
What’s exempt — what Medicaid doesn’t count?
Your primary residence (subject to equity limits), one vehicle, household goods, a prepaid burial plan, and certain retirement accounts.
Exempt assets generally don’t affect eligibility while you’re alive — though the home may still face Medicaid estate recovery after death unless it’s held outside the probate estate.
What is the spend-down requirement?
To qualify, countable assets generally must drop below a small statutory limit. Spend-down is what happens to assets above that line before benefits begin.
| Spend-down move | Allowed | Not allowed |
|---|---|---|
| Care costs paid directly out of pocket. | ||
| Exempt-asset purchases (home improvements, vehicle). | ||
| Prepaid funeral and burial expenses. | ||
| Paying off legitimate debts. | ||
| Gifts within the five-year look-back without penalty. | ||
| Selling assets below fair market value. | ||
| Hidden transfers to family. | ||
| Last-minute restructuring of countable assets. |
What happens to a married couple’s assets?
Married couples have separate rules. The community spouse — the one not entering care — keeps a protected share of countable assets and a minimum income allowance.
Spouse entering care
The applicant spouse
Subject to spend-down on countable assets. Must qualify within the asset limits. Income generally must be applied to care. Eligibility depends on the couple’s total picture.
Spouse remaining at home
The community spouse
Keeps a protected resource amount. Receives a minimum monthly income allowance. Retains the home and one vehicle. Continued financial stability is the goal.
How Brent helps you
- Walks through your specific assets and tells you what would count and what wouldn’t
- Maps the spend-down path that fits your circumstances
- Coordinates spousal protections so the community spouse stays financially stable
- Builds a MAPT in advance when the timing is right to keep assets outside Medicaid’s count
What it looks like for one family
The same savings can be almost entirely countable or largely protected — knowing what counts is where planning starts.
Everything treated as countable
The spend-down is steep
The Caldwells assume all their savings must be spent before Medicaid helps. Without sorting countable from exempt assets, they spend down far more than the law actually requires.
Countable and exempt sorted out
Protections are used in full
By identifying exempt assets and applying the community-spouse protections, Peggy keeps the home, a vehicle, and a protected share of savings — while Bob still qualifies for coverage.
Bob, Peggy, and the Caldwell family are a composite example used to show how the rules apply — not a real client.