Financial Basics · Healthcare

Medicaid

Definition

Medicaid is a joint federal-state program that covers healthcare and long-term care for people with limited income and assets. For retirees, it's primarily a long-term care safety net that kicks in after personal assets are largely spent down.

Why it matters in retirement

Medicaid pays for about half of all long-term care in the US. If you don't have LTC insurance, it's likely where you'll end up if care lasts more than a few years. Understanding the 5-year lookback, spousal protections, and spend-down rules is essential for anyone planning for late-life care.

Key Numbers — 2026

Asset limit (individual, most states)
$2,000
Community spouse asset allowance
~$157,920
Lookback period
5 years
% of nursing home residents on Medicaid
~60%

Pros

  • Covers long-term care Medicare doesn't
  • Spousal protections preserve a portion of assets
  • No premiums

Cons

  • Strict asset limits
  • Limited provider choice
  • 5-year lookback penalizes gifts
  • Estate recovery can claim home at death

Common mistakes

  • Gifting assets within 5 years of needing care
  • Assuming Medicaid and Medicare are the same
  • Not protecting the community spouse's share
  • Ignoring estate recovery when planning

Related

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