Ways To Protect Your Home From MassHealth Estate Recovery
Dale Tamburro • December 24, 2025

WAYS TO PROTECT YOUR HOUSE FROM MASSHALTH ESTATE RECOVERY


In most instances, you can own a home and still get MassHealth coverage of your health or long-term care. While MassHealth has strict income and asset limits on eligibility, in most cases it doesn't count the home against those limits. On the other hand, as I often say, while they don't get you coming, they will get you going. If you sell the house either during your life or upon your death, MassHealth will seek to recover its costs of paying for your care.


If you are living in your home and you or your spouse is receiving community benefits, there's no limit on the value of your home. Likewise, if you are receiving nursing home care and your spouse is living at home, you can keep it no matter its value. And even if you are single and in a nursing home, your house will not be counted against the MassHealth asset limit of $2,000 (for nursing home residents) as long as you (1) state an intent to return home and (2) your equity interest in the home has a value of less than $$1,071,000 (2024).

While you can keep your home in most instances, MassHealth has the right to recover its costs of paying for your care through two methods. The first is by putting a lien on the house to secure repayment in the event you sell the house. The second, known as "estate recovery," is its right to repayment from your probate estate at your death. In most cases, your only substantial asset at death will be your home, since the rest of your savings will have to be spent down to qualify for MassHealth in the first place.


With proper planning, both the lien and estate recovery can be avoided. In considering planning techniques, you will need to distinguish between advance planning and crisis planning. Advance planning involves taking steps well before any need for long-term care may occur. Crisis planning takes advantage of opportunities that may be available even after you have a need for long-term care. The four planning options described below all involve advance planning, each with its own pros and cons. In a future blog post, I will discuss crisis planning steps you may take to protect the home.

  1. Give it away. If you transfer your home to the ultimate beneficiary or beneficiaries of your estate, presumably your children, they will own it and it will not be subject to any claim by MassHealth. Be aware, however, that once you do so you will have a five-year wait for nursing home MassHealth due to its transfer penalty. An outright transfer also has the following drawbacks and risks: (a) You no longer own the house, so you will not be able to draw on its equity to pay your expenses without your children cooperating. (b) Likewise, you will not be able to sell the property and purchase another without your children's consent and cooperation. (c) Your children could decide that it's time for you to move from the house before you're ready. (d) Your children would face a higher tax on capital gain on the sale of the house both during your life due to the loss of the homeowner's $250,000 exclusion or after your death due to the loss of the so-called "step up" in basis upon your death. (e) The house could be subject to claim if one of your children were sued, went through a divorce, or passed away before you.
  2. Life estate.  A life estate is a form of joint ownership where the life estate owner has the exclusive right to live in the property during his life and then at his death it passes automatically to the so-called remaindermen. Since it avoids probate, MassHealth has no claim for estate recovery after you pass away. Contrasting the life estate with the drawbacks of an outright transfer, (a and b) you would still need your children's cooperation to sell or mortgage the property during your life. If it were sold, the proceeds would be divided between you and your children based on tables that take into account life expectancy and current interest rates, the older you are, the smaller your share and the larger the share of the remaindermen. Your share would be subject to claim for reimbursement to MassHealth. (c) No one can kick you out of the house. (d) Your children would receive a step up in basis at your death, avoiding an unnecessary tax on capital gain after you pass away. If you sold the house during your life, you could use your $250,000 exclusion against your share of the proceeds but not to reduce the tax on the capital gains attributable to your children's share. (e) While the ownership interest of each of your children in the life estate could be subject to claim during your life, no creditor or ex-spouse could take possession. Your right to occupy the premises would continue. To learn more about life estates, click here and here.
  3. Irrevocable trust. A transfer of your home to an irrevocable trust for your benefit has certain advantages and disadvantages in comparison to an outright transfer or a life estate. Reviewing the same elements, (a) unlike the other two options, you would not need your children's cooperation to sell the house. (b) However, you probably would not be able to get a conventional mortgage or line of equity for a property in an irrevocable trust. (c) As with the life estate, you could stay in the house as long as you liked. (d) After your death, your children would get a step up in basis as with the life estate. It's not clear whether you would be able to use the $250,000 capital gains exclusion for a sale during your life. MassHealth has been attacking irrevocable trusts (more on this below), which has meant that we and other elder law attorneys are drafting them in ways that are more restrictive and thus no longer guarantee use of the capital gains exclusion. (e) The irrevocable trust protects your home from any claim or unfortunate circumstance happening to your children. The main drawback of an irrevocable trust over a life estate is that it cannot be reversed if you were to need care during the five years following its creation. While the creation of both a life estate and a trust create a five-year transfer penalty, if they're cooperative your children can convey back their interest in a life estate in case you needed MassHealth coverage during the subsequent five years and, as a result, undue the transfer penalty. This is not possible with an irrevocable trust. Advantages of the trust over the life estate include total protection of the proceeds of a sale during your life and protection for the home and for you in the event your children fall on hard times or disagree with you on how to manage the property.
  4. Long-term care insurance. If you are insurable and can afford to purchase long-term care insurance, doing so can have at least two highly beneficial results. First, you will be less likely to need MassHealth because of your insurance coverage and even if you do ultimately need to apply for benefits. Second, MassHealth has a unique regulation that exempts the home from estate recovery if the owner has remaining long-term care insurance benefits when she moves to a nursing home. In other words, this exemption applies if she hasn't used up all of her benefits on home health or assisted living care. Of course, the issues of insurability and affordability may rule long-term care insurance out as an option.

As you can see, the pros and cons of these approaches are complex and it's difficult to predict in advance which will be the most beneficial for each client. However, each client's situation will include factors that argue for using one approach or another. An experienced elder law attorney can help you make this determination.


8 More Ways to Protect Your Home from MassHealth Estate Recovery: Part 2


The four steps I described all need to be taken at least five years before you apply for MassHealth. But what do you do if you can't wait five years, if you or a loved one already needs assistance or the writing is on the wall?

First, don't panic. MassHealth may well have a claim against your house or your loved one's house, but it might not be as much as you fear, in large part because MassHealth pays less for care than facilities charge on the private market. For instance, let's assume your mother is in a nursing home that charges $12,000 a month privately. MassHealth may only pay $8,000 a month. In addition, your mother must contribute her income. If that is $3,000, than MassHealth's out-of-pocket cost will be $5,000 a month or $60,000 a year, which will also be its claim against the house. While this is a lot of money, it would take 10 years to completely use up the equity of a home with a market value of $600,000, much longer than almost anyone lives in a nursing home. MassHealth's claim for home care will almost certainly be less because its cost will be less.


Second, in many cases you can either reduce or totally avoid this claim, even without advance planning. Here's how:

  1. Rent out the house. Rental income will help defray expenses for maintaining the house and the net income will have to be contributed to the cost of care. This reduces MassHealth's cost and it's claim against the house. In our example above, if you rented out your mother's house and earned $2,000 a month after expenses, this would reduce MassHealth's out-of-pocket costs from $5,000 to $3,000 a month, and its claim from $60,000 for a year of care to $36,000, substantially reducing estate recovery upon your mother's death.
  2. Transfer to a spouse. MassHealth's claim only applies to the estate of the person receiving benefits and there are no restrictions on transfers between spouses. So, if your mother is in a nursing home and your father is still living at home, it usually makes sense for your mother to transfer the house to your father. However, he also needs to sign a new will because it he dies before your mother, it won't help much if the house goes right back to her.
  3. Transfer to a caretaker child. If you or one of your siblings lived with your mother for at least two years before she moved to a nursing home and a doctor will attest that due to your assistance your mother was able to delay moving to the nursing home for two or more years, then you (or your sibling) can qualify for an exception to the usual five-year penalty for transferring the house. Your mother can deed it over to you (or your sibling) and since it won't be in her estate it won't be subject to claim when she dies. Be aware, however, that there may be adverse tax consequences to such a transfer, so before taking this step, consult with an experienced elder law attorney.
  4. Transfer to sibling with equity interest. While much less common than the caretaker child exception, MassHealth also exempts transfers to siblings who already have an equity interest in the home and who lived with the nursing home resident for at least a year before she moved to the nursing home. So, for instance, if your mother owned her home with her sister, and they lived together for at least a year before your mother moved to the nursing home, she could freely transfer the home to your aunt.
  5. Transfer to disabled child. If you or one of your siblings is disabled, as evidenced by receiving Supplemental Security Income or Social Security Disability Income, then your mother can transfer the house to your or to that sibling without penalty.
  6. Transfer to trust for disabled individual under age 65. In addition to being able to transfer the house to a disabled child, your mother can transfer it into trust exclusively for the benefit of anyone who is disabled and under the age of 65, whether or not that person is her child. This can include grandchildren and in-laws.
  7. Transfer to anyone, if not in a nursing home. The penalty for transferring assets only applies to MassHealth coverage of nursing home care, not to community benefits. If your mother or other loved one is receiving care at home, she can avoid MassHealth's claim by transferring the house to anyone. However, this might not be advisable given that (1) MassHealth's claim is likely to be smaller in this case than for nursing home care, (2) this could cause problems if your mother were to need to move to a nursing home within five years, and (3) there could be adverse tax consequences.
  8. Hardship waiver. If one or more of the people who inherit the house are low income and live i the house, they may qualify for a hardship waiver from MassHealth's estate recovery claim. Unfortunately, MassHealth's requirements to qualify for this waiver are extremely (inordinately, in my opinion) restrictive, so if you do qualify make sure that you follow the hardship waiver rules very carefully.
  9. 

A number of these possible steps can cause difficulties, especially since some involve transfers to one child when the parent may want her estate to pass equally to all of her children. Others have tax implications that can undercut their benefit. As a result, we strongly recommend consulting a qualified elder law attorney before embarking on any of these strategies.




By Dale Tamburro September 17, 2026
7 Steps Before Meeting With an Estate Planning Attorney Takeaways You do not need to have every estate planning decision finalized before meeting with an attorney. A basic inventory of your assets can help you avoid overlooking important property or accounts. Identifying potential beneficiaries and an executor can make the conversation with your attorney more productive. Blended families, minor children, beneficiaries with disabilities, and other family circumstances may require special planning. Existing wills, trusts, and beneficiary designations should be reviewed together as part of your overall estate plan. Making a will is easier when you prepare before meeting with an estate planning attorney. You do not need to have every decision finalized, but gathering information about your assets, loved ones, and wishes can help your attorney understand your situation and identify issues that may need special attention. Your attorney can help evaluate your options and decide what type of estate plan is right for you. Here are seven steps to take before a meeting with an estate planning attorney. 1. Make a Basic List of Assets Your assets are everything you own, including: Your home or other real estate Bank and investment accounts Vehicles Valuable personal property, such as jewelry, artwork, collectibles, or family heirlooms Business interests Life insurance Making a list of everything you own can help you in several ways. First, it helps you take stock of your assets and avoid forgetting something you wish to include in your estate plan. Writing down your assets can also help you start to think about the people you may want to inherit your property. 2. Gather Important Documents If possible, gather copies of documents that may help your attorney understand your finances, family situation, and existing estate plan. You may want to bring: Any existing wills, trusts, or amendments Powers of attorney and health care documents Deeds or other records for real estate Recent bank, investment, and retirement account statements Life insurance policies Beneficiary designation forms Business ownership records Prenuptial or postnuptial agreements Divorce decrees or property settlement agreements Information about jointly owned property or accounts Documents relating to a beneficiary with a disability or special needs If you cannot find a document, make a note of the account or property, the institution that holds it, and its approximate value. This information may still help your attorney while you look for supporting records. Bring copies when possible and keep your original documents. Your attorney can tell you which documents are most important for your situation and whether anything else is needed. 3. Identify Your Beneficiaries Before your appointment, make a list of the people and organizations you may want to benefit from your estate plan. This could include: Your spouse or partner Children, stepchildren, grandchildren, or other family members Friends or other people who are important to you Charities, religious organizations, or other nonprofits For each person or organization, think about what you would like them to receive. You might want to leave someone a specific item, such as a piece of jewelry, a vehicle, or a family heirloom. You might also want to leave a specific dollar amount, a percentage of your estate, or the remainer of your property after other gifts have been distributed. Also consider backup plans. For example, who should inherit if a beneficiary dies before you? If you have minor children, should their inheritance be held in a trust until they reach a certain age? If a beneficiary receives government benefits or has difficulty managing money, should their inheritance be handled differently? You do not need to have all these decisions finalized before meeting with your attorney. Jotting down your initial thoughts can help your attorney explain your options and identify issues you may not have considered. 4. Think About Who Should Serve as Your Fiduciary Fiduciaries are the people you name in documents like health care proxies (proxy), power of attorneys (attorney-in-fact or agent), wills (personal representative or executor) and trusts (trustees). This individual should be someone you trust to act responsibly and ethically. You may also want to consider their ability to manage the administrative demands of the role. You also should have a backup in mind in case your first choice won’t or can’t act in the given role. 5. Note Family Circumstances That May Affect Your Plan Before meeting with an estate planning attorney, take note of any family circumstances that could affect your estate plan or how you want to distribute your assets. Important details may include: You have children from a previous relationship or a blended family You are unmarried or have a long-term partner You have minor children and need to consider who you would want to care for them if you and the other parent could no longer do so You have a child or other beneficiary with a disability A beneficiary receives needs-based government benefits You provide financial support for a parent, grandchild, or another dependent You want to leave different amounts or types of property to different family members You are considering leaving someone out of your will You have concerns about a beneficiary’s ability to manage money You own property with someone else or have a family business These circumstances do not necessarily mean that your estate plan will be complicated. However, they may affect whether a simple will is appropriate or whether you should consider additional planning, such as a trust. For example, a beneficiary with a disability who receives needs-based benefits may need an inheritance handled through a special needs trust rather than receiving it directly. 6. Gather Existing Beneficiary Designations Next, review your existing beneficiary designations. These may appear on retirement accounts, life insurance policies, and payable-on-death or transfer-on-death accounts, which often pass directly to the named beneficiaries and may not be controlled by your will. The rules can vary depending on the account and the way it is owned, so bring copies of your designations to your attorney. Through the estate planning process, some people find they want to change or revise their designations on accounts and policies. Others sometimes realize they still need to add a beneficiary. 7. Bring Questions for the Attorney Finally, think about any questions you may have for the attorney. You might want to ask about planning for pets, digital assets , best practices for document storage, or what other estate planning documents you may need. Thinking of questions in advance can help you make the most of your first appointment.
By Dale Tamburro September 17, 2026
 Takeaways Do not rush into selling, renting, or moving into an inherited house before confirming ownership and financial obligations. Your main options may include moving in, selling the property, renting it, or buying out other heirs. Inherited real estate generally receives a new tax basis tied to its value when the owner died, but the tax result depends on the property and the transaction. Disagreements among siblings, Medicaid concerns, trusts, mortgages, and out-of-state property may require advice from an attorney or tax professional. Inheriting a house can create both financial opportunities and difficult decisions. The property may be a valuable asset, a family home filled with memories, or an expensive responsibility that you do not want to manage. You may be wondering whether to move in, sell the property, rent it out, or share it with other heirs. Before choosing an option, confirm who owns the property, understand the costs, and consider the legal and tax consequences. Start With These Immediate Steps You do not have to decide the property’s long-term future immediately. But you should take steps to protect the house and understand the situation. Confirm Who Owns the Property Review the will, trust, deed, probate filings, and other estate documents. The person named in a will may not automatically have complete authority to sell or transfer the house while the estate is being administered. Ownership may also be affected by joint ownership, a transfer-on-death deed, an irrevocable or revocable turst or state-specific probate rules. Before signing a listing agreement or transferring the property, confirm that the correct person or people have authority to act. Protect and Maintain the House Make sure the property is secure and continues to have appropriate insurance coverage . Insurance agents must be notified of the death of the owner/occupant. If no one is occupying the property, the insurance cost will change. If the insurance agency is not notified you may be denied a later claim. Depending on the circumstances, you may also need to: maintain utilities pay property taxes address urgent repairs protect the house from weather or other damage If the property has a mortgage, home equity loan, or reverse mortgage, contact the loan servicer. Do not assume that you can simply ignore the loan or transfer it to an heir. The estate documents, loan terms, and applicable law may affect what happens next. Gather the Financial Information Collect documents showing: The current mortgage balance and monthly payment Property taxes and insurance costs Homeowners association fees Utility and maintenance expenses Liens or other claims against the property Recent appraisals or assessments Records of major improvements Rental income, if the property was previously rented This information can help you compare the cost of keeping the property with the likely proceeds from selling it. Should You Move Into the Inherited House? Moving into the house may make sense if it is in a location you want, meets your needs, and can be maintained within your budget. Before moving in, consider: Whether the house needs repairs or accessibility modifications The cost of property taxes, insurance, utilities, and maintenance Whether there is a mortgage or other debt Whether you can afford the house over the long term Whether other heirs also have ownership rights Whether moving would affect your work, health care, or family responsibilities If you inherit the property with siblings or other people, moving in does not necessarily give you the right to make all decisions about the house. Co-owners may need to agree about repairs, expenses, use of the property, and whether anyone should pay rent. Put agreements among co-owners in writing. A written agreement can address who may live in the home, which expenses each person will pay, how repairs will be approved, and what happens if someone later wants to sell. Should You Sell the Inherited Property? Selling may be the most practical option when multiple heirs want to divide the asset, the property is expensive to maintain, or no one wants to live nearby. Before listing the house, consider: Its current market value Needed repairs and preparation costs Real estate commissions and closing costs Existing mortgages, liens, and unpaid taxes The timing of the probate or trust administration Whether all owners must sign the sale documents The possible income tax consequences A sale can provide a clean separation among heirs. However, disagreements about the listing price, repairs, timing, or distribution of proceeds can delay the process. An appraisal may help establish a fair value before one heir buys out the others or the property is listed. Should You Rent the Inherited House? Renting the property may create income and allow the family to keep the home as an investment. It also creates ongoing responsibilities. Consider the cost of: Property management Repairs and routine maintenance Insurance and property taxes Vacancies and unpaid rent Tenant screening and legal compliance Accounting and income tax reporting Disagreements among co-owners If several people inherit the house, decide in advance who will manage it, how rental income will be divided, and how large expenses will be approved. A property that produces rental income can still be a poor investment if the owners cannot agree or the maintenance costs are too high. What If You Inherited the House With Siblings? When siblings inherit a house together, the property cannot be physically divided as easily as cash or investments. The heirs generally need to agree on one of several arrangements. Options for Handling a House Inherited With Siblings Option May Work Best When Main Issue One heir buys out the others One person wants to keep the home Agreeing on a fair value and payment terms Sell the property The heirs want to separate their interests Repairs, sale costs, timing, and division of proceeds Rent the property Everyone wants ongoing income Management, expenses, vacancies, and future disagreements Mediate the dispute The heirs disagree but want to avoid court Everyone must participate in good faith If the heirs cannot reach an agreement, a court proceeding may be available in some states to resolve co-ownership disputes. The rules and procedures vary, so consult an attorney in the state where the property is located before taking legal action. What Are the Tax Consequences? The tax consequences depend on a variety of factors, including: the property’s value how it is used when it is sold the applicable state law For federal income tax purposes, the basis of inherited property is generally its fair market value on the date the owner died. If you sell the property for more than your adjusted basis, you may have a taxable gain. If you sell it for less, you may have a loss, although the tax treatment can depend on how the property was used. The Internal Revenue Service (IRS) explains how basis applies to inherited property . The IRS also provides information for executors and administrators about selling or disposing of inherited property in Publication 559 . Keep documents showing the property’s value at the owner’s death. Also hold on to appraisal reports, improvements, selling expenses, and other costs. Ask a tax professional how to determine and document the basis before filing a return or completing a sale. When Should You Get Legal Advice? Consider consulting an attorney before making a major decision if: The property is still going through probate A trust owns the property Multiple heirs disagree about what to do One heir wants to live in the house The property has a mortgage or reverse mortgage The home is located in another state A beneficiary receives Medicaid or other needs-based benefits The property may be subject to estate recovery Someone wants to give or transfer their share to another person There are questions about undue influence, debts, or the validity of the will An elder law or estate planning attorney can help coordinate the property decision with Medicaid planning, trusts, incapacity planning, and the rest of the estate. Learn more about using estate planning to prepare for Medicaid and the difference between elder law and estate planning . Questions to Ask Before Deciding Before moving in, selling, renting, or agreeing to share the property, ask: Who legally owns the property right now? What debts, taxes, insurance, and repairs must be paid? What is the property worth in its current condition? What does each heir want to happen? Can the heirs afford to keep the property? What will happen if one heir changes their mind later? What are the legal and tax consequences of each option? Answering these questions can help the family make a decision based on financial facts rather than pressure or emotion. Make a Decision That Fits Your Circumstances There is no single best choice for every inherited house. Moving in may preserve a family home but create ongoing costs. Selling may provide clarity but require difficult conversations. Renting may produce income but comes with landlord responsibilities. Keeping the property with siblings may work, but only if the owners have a clear agreement. Take time to understand the property and document its value. Communicate with the other heirs and obtain professional advice when the situation is complicated. A thoughtful decision can help protect the value of the inheritance and reduce future conflict.