Medicaid in 49 states and DC has a 5 year look back period (California is 30 months/2.5 years) on transactions/disbursements with regards to intentional impoverishment. Something to consider when estate planning.

https://www.medicaidplanningassistance.org/medicaid-look-bac...

> Medicaid in 49 states and DC has a 5 year look back period (California is 30 months/2.5 years)

California is also phasing out the asset test, which will eliminate the need for a look-back period entirely (asset limit moving from $2k/$3k for individual/couple to $130k/$195k this July, planned for total elimination by July 2024.)

> Anyone in the US who is middle-class likely will have to sell their home or put it into a financial trust by the time they become very old in order to qualify for Medicaid,

In most states, your home is exempt (at least to certain far above median value, equity limit) from the Medicaid asset test, so, no, you probably won't.

You should. While it's true that your primary residence won't be counted as an asset in order to qualify you for Medicaid, they can and will place a lien on the property if you ever enter into a nursing facility (and maybe in some other situations). This allows them to capture the proceeds if the house is sold while you're living or (in some states?) from your estate when you die.

Older families should strongly consider placing their home into some kind of trust or transferring ownership to a descendant before this becomes an issue.

“Will want to because of potential downstream inconveniences of” and “will have to in order to qualify for” are...very different things.

That's true, but I don't think most people would put, "the state sold the house my mom has lived in since 1972 and kept the proceeds" in the "downstream inconveniences" bucket. It's a pretty big deal! The whole point of getting approved for Medicaid is that you won't have to go broke paying for your healthcare (at which point you'd qualify for Medicaid, anyway).

    >> certain Medicaid benefits

Assisted Living and Nursing Homes. Medicare makes you burn thru your assets before they start paying.

You get charged $5K/month until you are broke. Then Medicare pays the place 1/3 that price for the same care.

Largest wealth confiscation scheme ever seen. Inheritance? No, sorry.

Medicare is the standard retirement healthcare plan and all Americans are eligible if they worked a minimum of 10 years.

Medicaid is for the destitute so of course you need to spend down assets to access it.

According to the American Council on Aging, "In most cases, one’s home, home furnishings, and vehicle are exempt." (from the asset test).

Yes, from the asset test required to qualify you for Medicaid. But if you enter into a nursing facility, for example, then they'll place a lien on the property and collect if the house is sold while you're alive or from your estate when you die (assuming there's no living spouse).

You really want to have a plan for your primary home before this becomes an issue. The asset test is only one concern.