By Tim Barkley. July 2025.
Susan sat across the table, flipping through a manila file. “I think I have everything you asked me to bring.”
The lawyer flipped through the proffered folder. “To see if your mom qualifies for Medicaid, we need to know what she owns and what it’s worth.”
He stood and wrote two headings on the whiteboard: Exempt and Countable.
“Exempt assets aren’t counted when applying for Medicaid. Countable assets are. Medicaid requires that countable assets be reduced below $2,500 for a single person to qualify.”
He sketched a crude car under “Exempt.” Susan looked puzzled. “That’s a car,” he explained. “Your mom can keep one, even if she doesn’t drive, because it may be needed for medical appointments. It just has to be reasonable — no luxury vehicles.”
Next, he drew a small semicircle labeled “RIP.” “She can prepay funeral and burial expenses, within reasonable limits.”
“What’s ‘reasonable’?” Susan asked.
The lawyer shrugged. “If you can justify it to a Medicaid caseworker without blushing, it’s probably reasonable.”
“What about her house? It’s worth about $300,000.”
“If your father were living there, the house would be exempt. He’s passed away, but there are still options. If rented, the income could help pay for her care and the house wouldn’t be counted against the $2,500 limit. Medicaid—specifically the Maryland Department of Health—will place a lien on it so that they get repaid for their payment toward her cost of care, but the lien is only enforceable when the property is sold.
“The lien only covers what Medicaid pays. For example, let’s assume the nursing home charges $10,000 monthly. Medicaid only pays 50%, or $5,000. The nursing home has to accept that as payment in full. The Medicaid lien would be for only $5,000 per month, not the $10,000 private pay rate, so the value of the house would last twice as long as if it were sold and the money used to pay the nursing home. It’s much more likely that there will be residual value for your inheritance. In short, keeping the house with a Medicaid lien can preserve assets.
“Even better, if she is living in the house with a child caregiver who is also on title, and if her doctor will certify that the child’s care kept her out of a nursing home for 2 years, the house is exempt and there’s no lien.”
Susan exhaled. “I just hear so many horror stories about nursing homes ‘taking’ everything.”
“A myth,” the lawyer assured her. “They don’t take anything. They just need to be paid.”
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Attorney Tim Barkley
The Tim Barkley Law Offices
One Park Avenue
P.O. Box 1136
Mount Airy
Maryland 21771
(301) 829-3778
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