Below are the questions we hear most often about elder law in our Murrysville office, answered in plain language by attorneys who handle these matters every day in Western Pennsylvania.
Frequently Asked Questions
How do I protect my assets from nursing home costs in Pennsylvania?
Asset protection planning should begin as early as possible — ideally before any health crisis arises. Strategies may include irrevocable trusts, strategic gifting, and retitling of assets. Pennsylvania Medicaid has a 5-year look-back period, meaning any transfers made within 5 years of applying for Medicaid may result in a penalty period during which the applicant is ineligible for benefits. The earlier you start planning, the more options are available. We evaluate each family's situation and develop a strategy that balances asset protection with practical access to resources.
What is the 5-year Medicaid look-back period?
When someone applies for Medicaid to pay for nursing home care in Pennsylvania, the Department of Human Services reviews all financial transactions from the previous 60 months (5 years). If assets were transferred for less than fair market value during that period — such as gifting money to children or transferring property — a penalty period is calculated during which the applicant cannot receive Medicaid benefits. The penalty is based on the total value of transfers divided by the average monthly cost of nursing home care. Planning well in advance of a potential need is the key to avoiding look-back penalties.
What is the difference between Medicare and Medicaid for long-term care?
Medicare is federal health insurance primarily for people 65 and older. It covers hospital stays, doctor visits, and limited skilled nursing care (up to 100 days after a qualifying hospital stay), but it does not cover long-term custodial care — the kind of daily assistance most nursing home residents need. Medicaid is a joint federal-state program that does cover long-term nursing home care, but only for people who meet strict financial eligibility requirements. Most families need to plan ahead to qualify for Medicaid without impoverishing the healthy spouse.
Can the nursing home take my house?
The nursing home itself cannot take your house. However, if you apply for Medicaid, your home may be considered a countable asset depending on the circumstances. Generally, your home is exempt from Medicaid eligibility calculations if your spouse or a dependent relative lives there, or if you intend to return home. After a Medicaid recipient dies, Pennsylvania's estate recovery program can seek reimbursement from the recipient's estate — including the home. Proper planning can protect the home from estate recovery in many situations.
What is VA Aid and Attendance?
Aid and Attendance is a pension benefit available to wartime veterans (and their surviving spouses) who need assistance with activities of daily living — such as bathing, dressing, eating, or ambulating — or who are housebound. The benefit provides a monthly tax-free payment that can help cover the cost of home care, assisted living, or nursing home care. Eligibility requires qualifying military service during a period of war, financial need, and medical need. The VA also has a 3-year look-back period for asset transfers.
When is it too late to do asset protection planning?
It is never too late to evaluate your options, but the range of available strategies narrows significantly once a health crisis has occurred or nursing home admission is imminent. Transfers made within the 5-year Medicaid look-back period may trigger penalties, and transfers made when someone lacks mental capacity may be invalid. The best time to start planning is when you're healthy. The second-best time is today. Even in crisis situations, there are often steps that can protect the healthy spouse and preserve some family assets.
Should I put my house in my children's names to protect it?
This is one of the most common — and most dangerous — asset protection mistakes families make. Transferring your home to your children exposes it to their creditors, their divorces, and their financial problems. It triggers a Medicaid look-back penalty if you need nursing home care within 5 years. It eliminates the stepped-up tax basis your children would receive if they inherited the property, potentially creating a large capital gains tax liability when they sell. And it gives them legal authority to sell or mortgage the property without your consent. There are almost always better alternatives.