The decision to move into a nursing home can be an emotional time, bringing with it anxiety and uncertainty.  One of the biggest questions many people in North Carolina face is whether Medicare can claim their home if they end up needing long-term care. 

Your home isn’t simply bricks and mortar—it symbolizes all of your hard work, your memories, and your legacy.  It’s only natural to wonder how it might be affected by healthcare needs later in life. At Salines-Mondello Law Firm, PC, we understand how important it is to protect your assets. 

Let’s clear up some of the confusion about what Medicare can and cannot do when it comes to your home, and most importantly, how Medicaid plays a much bigger role in long-term care planning.

Medicare and Long-Term Care: Setting the Record Straight

Many people mistakenly believe that Medicare will take care of their long-term nursing home needs.  While it’s true that Medicare is an essential safety net for medical expenses, its role in long-term care is quite limited.

Medicare’s Limited Role

So, what is Medicare designed to cover? It essentially covers medical services like doctor visits, hospital stays, and even short-term rehabilitation. But when it comes to long-term care in a nursing home, Medicare isn’t much help. If you’re relying on it to cover extended nursing home stays, you may be in for a surprise.

100-Day Rule

Here’s the deal: Medicare will only cover up to 100 days of skilled nursing care, and that’s only after a qualifying hospital stay of at least three days. Even then, the coverage isn’t comprehensive. 

For the first 20 days, Medicare might pick up the full tab, but after that, you’ll be expected to pay a daily copayment, of upward of $200 per day. By day 101, Medicare coverage ends completely.

Custodial Care Exclusion

Most nursing home residents need custodial care, which includes help with daily activities like eating, bathing, and dressing. Unfortunately, Medicare doesn’t cover custodial care at all, leaving many people to seek other options.

Hospice Exception

The only exception is if you’re in hospice. Then, Medicare might cover some custodial care. But this only applies in very specific situations and is more focused on end-of-life care than long-term support.

Medicaid: The Safety Net for Long-Term Care

While Medicare falls short on covering long-term care, Medicaid can step in to help. Medicaid is a state and federally-funded program that covers a broader range of care services for those who qualify, including long-term nursing home stays. In North Carolina, Medicaid can provide substantial assistance, but it’s crucial to meet certain financial and asset criteria.

Medicaid’s Broader Coverage

Unlike Medicare, Medicaid is set up to help with long-term care costs, including nursing home stays. However, it’s a means-tested program, meaning eligibility is based on your income and assets. Planning ahead can help you qualify while still protecting your assets, including your home.

Eligibility in North Carolina

Medicaid eligibility in North Carolina hinges on meeting strict financial criteria.Your income and assets must fall below certain limits, but don’t assume that you need to “spend down” everything you own to qualify. There are strategies to protect your home and other valuable assets while ensuring you get the care you need.

Look-Back Period & Penalties

Be mindful of the five-year look-back period. Medicaid reviews any asset transfers made in the five years before applying for benefits. If they find that gifts or uncompensated transfers have reduced assets, you could face penalties that delay eligibility for coverage. 

It’s always better to plan ahead with an Elder Law attorney rather than make last-minute decisions that could cause more harm than good.

Protect Your Home and Legacy in North Carolina: Proactive Strategies

Many seniors worry that applying for Medicaid will mean losing their homes. The good news is that North Carolina offers several protections to ensure your home isn’t automatically lost if you enter a nursing home.

When Your Home is Exempt in NC?

In most cases, your home is exempt from Medicaid recovery while you or your spouse is still living there. In 2024, North Carolina law allows you to protect up to $713,000 in home equity.

Additionally, there are exceptions if your spouse, a minor child, or a disabled family member continues to live in the home.

Beyond Exemptions: Strategic Planning

For those looking to go beyond basic exemptions, there are additional planning strategies to safeguard your home. An option to look into is setting up and funding a Medicaid asset protection trust, which can protect assets while allowing you to qualify for Medicaid. 

The Power of Professional Guidance

Medicaid rules can be complicated, and making a mistake could cost you dearly. That’s why it’s important to seek the advice of an experienced Elder Law attorney who understands the nuances of Medicaid planning. 

Every family’s situation is different, and having a personalized plan in place can make all the difference.

Secure Your Legacy, Contact Salines-Mondello Law Firm, PC Today

Your home represents years of hard work and love. Don’t leave its future to chance or wait until it’s too late to protect it. 

The sooner you start planning, the better off you and your family will be. At Salines-Mondello Law Firm, PC, we are committed to helping families in North Carolina protect what matters most—your home, your family, and your future.

Call us today at (910) 541-5776 and take the first step toward securing your legacy. We’re here to provide the peace of mind that comes with knowing your loved ones will be taken care of, no matter what the future holds.