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The gift you made three years ago can cost ten months of nursing-home private pay.
Medicaid long-term care eligibility is three separate tests, and families routinely fail the one they didn't know existed. Assets: a single applicant keeps just $2,000 of countable assets; a married couple protects $32,532–$162,660 for the spouse at home (2026 CSRA). Lookback: every gift or below-market transfer in the last 60 months is divided by your state's penalty divisor to produce months of ineligibility — and the penalty clock starts only after you're broke and in care, so a $100,000 gift can mean $95,000+ of private pay with nothing left. Income: over $2,982/month needs a Miller Trust in most states. This calculator runs all three tests at once.
Adult children use it the week a parent needs a nursing home, when the family learns the $2,000 asset limit, the spouse's protected share, and that the $100,000 gifted three years ago now means ten months of private pay — the three-test reality check before the elder-law attorney meeting.
Cash, checking/savings, brokerage accounts, stocks and bonds, second properties, and in most states retirement accounts NOT in payout status. Exempt: the primary home up to $752,000 of equity (2026) while a spouse or dependent lives there or you intend to return, one vehicle, household goods, prepaid irrevocable burial arrangements, and term life insurance with no cash value. The classification decides everything — the same dollar is protected in an exempt form and counted in a countable one.
Uncompensated transfers inside the 60-month lookback are summed and divided by your state's penalty divisor (2026 examples: Florida $10,645/mo, Arkansas $6,083, Alaska ~$25,000; some states use daily divisors like NJ $420.67/day). The result is months of ineligibility that begin only when you are otherwise eligible and receiving care — so you must private-pay with the assets you no longer have. A $100,000 gift at Florida's divisor = 9.4 penalty months ≈ $95,810 of nursing costs out of pocket.
Yes — spend-down is only penalized when assets are given away below fair value. Lawful moves: pay off the mortgage or make home repairs (builds exempt home equity), buy a Medicaid-compliant annuity that converts countable assets to an income stream for the community spouse, prepay an irrevocable burial trust, replace the old car. Done 5+ years ahead, irrevocable trusts can protect more. After death, Medicaid estate recovery can claim the home — planning around that is elder-law attorney territory and worth the fee.