When someone applies for MassHealth long-term care coverage, one of the first questions that comes up is:

"What happens to my house?"

Well, it depends on your situation. Let’s break it down in simple terms so it’s easy to understand—no legal jargon, just real talk.

If You Own More Than One Home

Bad news first:

If you own more than one property—like a vacation home, land, or rental property—you won’t qualify for MassHealth until you sell those extra properties and use the money first.

Only your primary residence can be protected, and even that depends on your specific case.

If You’re Single

Good news: There’s no home equity limit if you’re single. But...

• You must make a good faith effort to sell the home within 9 months after getting MassHealth.
• While it’s for sale, your home won’t count against you.
• You must prove you’re trying to sell it—things like real estate listings or offers from buyers.
• If you turn down a reasonable offer (at least two-thirds of what it’s worth), MassHealth can cut off your benefits unless you have a good reason.

Once the home is sold:

• Medicaid MassHealth may place a Lien on your home, once the home is sold Medicaid MassHealth may recoup any long-term care costs
• Any money left after Medicaid MassHealth recoups the long-term care costs will be considered countable assets and if you have more than $2,000, you could lose eligibility until you spend it down.

How to Spend Down Legally:

• Pre-pay for your funeral or burial with a special trust or savings account (up to $1,500).
• Buy medical or personal items: glasses, dentures, clothes, wheelchair, TV, etc.
• NOTE: Keep receipts for larger purchases in case MassHealth requests proof that funds were used appropriately.

If You’re Married and Your Spouse Still Lives in the Home

If you're married and your husband or wife still lives in your house, MassHealth will usually protect your home—but there’s an important rule you should know:

• Massachusetts has a home equity limit for Medicaid: In 2025, that limit is $1,097,000.

What is home equity?

• It’s the value of your home minus what you still owe on it (like your mortgage).

So, what happens?

• If your home equity is below $1,097,000, MassHealth will not count it against you.
• If your home equity is over $1,097,000, you can still protect the home by transferring full ownership to your spouse.

This kind of transfer is allowed and doesn’t come with a penalty under MassHealth rules.

Once your spouse becomes the only owner of the house:

• The home is now completely exempt, even if it’s worth more than $1,097,000.
• And it won’t count against your $2,000 asset limit when applying for MassHealth.

What About Later? (Estate Recovery)

If MassHealth helped pay for your care, they may try to get that money back after your spouse passes away.

But here’s the good part:

• They can only recover the extra amount over the home equity cap.

For example:

If your home is worth $1.2 million, and the limit was $1,097,000, MassHealth might recover up to $103,000—but not more.

If You’re Married but Your Spouse Doesn’t Live in the Home

Things get trickier.

• If your spouse doesn’t live there, the home becomes countable.
• But you can still get approved if you agree to make a good faith effort to sell the home within 9 months of being approved
• MassHealth will consider the home a non-countable asset during the listing/sale period.
• Just like if you are single, you must prove you’re trying to sell and accept reasonable offers.

MassHealth may put a lien on the home, and when it sells, they may take back what they paid.

• After that, any remaining profits from the sale of the home counts toward your $2,000 limit, and you may need to spend it down before staying on MassHealth.
• You can use the same spend-down strategies as mentioned earlier.

Special Exception: Blind or Disabled Children

If you have a child of any age who is blind or permanently disabled, you’re allowed to:

• Transfer your home to them—no penalty.
• This does not break the 5-year “look-back” rule.
• MassHealth won’t disqualify you.

Just make sure:

• The child meets SSI disability standards.
• You keep proof of disability, like a Social Security award letter.
• Heads-up: MassHealth may try to recover costs after your child passes away or moves out.

More Ways to Avoid Estate Recovery

MassHealth won’t go after your home later if any of the following people live there:

• A child under 21.
• An adult child who lived with you and took care of you for at least 2 years before you went into a nursing home, and Provided care that delayed the recipient’s need for institutional care,
• A sibling who: Has ownership in the home, Lived there for at least 1 year before you entered care.
• If the property is your family’s only source of income, like a working farm or rental property.

Final Thoughts

MassHealth doesn’t automatically count your home as an asset—but rules change based on your marital status, who lives in the house, and how much your home is worth.

If you plan ahead, follow the rules, and document everything, you may be able to keep your home and still qualify for help.