The short answer
In every state, a primary home is exempt from Medicaid's asset limit while the applicant lives in it, intends to return to it, or a spouse or dependent child still lives there. Medicaid will not force a sale of the home to pay for care while your parent is alive. Where families get caught off guard is what happens after the Medicaid recipient passes away.
Estate recovery: the part people don't expect
Every state runs a Medicaid Estate Recovery Program. After a Medicaid recipient dies, the state has the right to seek reimbursement for long-term care costs it paid from the recipient's estate — which can include the home if it's still in the estate at that point. This is a federal requirement, not a state choice, so it applies no matter where you live, though the specific rules and exemptions vary by state.
Estate recovery does not apply while a surviving spouse is alive and living in the home, and most states also protect the home if a disabled or minor child continues to live there. Proper legal planning with an elder law attorney — done ahead of time, not after a crisis — can also protect the home in many cases.
Virginia specifics
Samantha's home base is Northern Virginia, so here's how it works there specifically: Virginia's home equity limit for Medicaid eligibility is $730,000 (2026). The home is protected from being counted as an asset as long as the applicant intends to return home, or a spouse or dependent lives there. Virginia's Estate Recovery Program can seek reimbursement after death, but it does not apply while a surviving spouse is living in the home. An elder law attorney can help structure things — legally and commonly — to protect the home ahead of time; this is often called Medicaid planning.
If you're outside Virginia, the same general shape applies (home protected during life, estate recovery after death, spousal protections), but your state's specific home equity limit and recovery rules will differ — your state Medicaid office or an elder law attorney licensed there can tell you the exact numbers.
What actually helps
- Talk to an elder law attorney before a crisis, not during one — timing matters for what planning options are still available.
- Don't transfer or sell the home below market value to try to protect it yourself — most states have a 5-year look-back period, and an improper transfer can create a penalty period that delays Medicaid eligibility entirely.
- Ask directly whether a spouse or dependent is living in the home — that fact alone changes the answer significantly.