Qualifying for Medicaid in Massachusetts requires passing strict financial eligibility tests. One of the most important steps in this process is understanding which assets are exempt (not counted) and which are countable (at risk of being spent down). Knowing the difference can help you and your family protect property while still getting the long-term care coverage you may need.
What Are Exempt Assets?
Exempt assets are those that Medicaid does not count when determining eligibility. These assets are protected, meaning you can keep them without affecting your ability to qualify for benefits. In Massachusetts, exempt assets generally include:
- Primary residence: Your home may be exempt if your equity interest is under $1,097,000 (2025 limit). You must declare an “intent to return home,” even if a return is unlikely.
- Personal property: Clothing, household furnishings, appliances, and other personal effects.
- One vehicle: A single car or truck, regardless of value, is typically excluded.
- Burial arrangements: Prepaid funeral contracts, burial plots, and up to $1,500 in a designated burial fund for you and your spouse.
- Life insurance: Whole life policies with a face value of $1,500 or less are exempt. Term life insurance is always exempt.
These exemptions mean that even if you need nursing home care, you do not automatically lose everything.
What Counts as a Countable Asset?
Countable assets include nearly everything else that can be converted to cash. Medicaid requires these assets to fall below a strict limit, typically $2,000 for an individual, before benefits will be approved. Examples of countable assets are:
- Bank accounts (checking, savings, credit union accounts)
- Certificates of deposit
- Stocks, bonds, and mutual funds
- U.S. savings bonds
- IRAs, 401(k)s, and other retirement accounts not in payout status
- Additional vehicles beyond the first
- Vacation homes, investment properties, or land other than your primary residence
- Certain trusts, depending on how they are structured
Because the list of countable assets is broad, most people will need to plan ahead to avoid exhausting their life savings before qualifying for coverage.
How Medicaid Protects the Spouse Who Stays at Home
Medicaid rules recognize the needs of a “community spouse,” or the spouse who remains at home while the other enters a nursing facility. Under the Massachusetts spousal impoverishment rules, the community spouse may keep:
- A portion of the couple’s combined countable assets, up to the Community Spouse Resource Allowance (CSRA) (2025 limit: $157,920).
- The family home, if the community spouse lives there.
- A minimum monthly income allowance, which may be supplemented by the institutionalized spouse’s income if needed.
This protection helps prevent the healthy spouse from becoming destitute while the other receives care.
Strategies to Protect Your Assets
With the right planning, you can preserve more of your estate while still qualifying for Medicaid. Common strategies include:
- Medicaid-compliant annuities: Converting excess assets into an income stream for the community spouse.
- Irrevocable trusts: Placing assets into a trust at least five years before applying for Medicaid so they are not considered countable.
- Exempt transfers: Certain transfers, such as to a disabled child, may be allowed without penalty.
- Spend-down planning: Using countable assets on exempt items, such as home improvements, before applying.
Each family’s situation is different, so working with an estate planning attorney is the safest way to create a strategy that preserves wealth while following Medicaid’s strict rules.
Why Planning Ahead Matters
MassHealth (the name for Medicaid in Massachusetts) has a five-year lookback period. This means any gifts or transfers made within five years before applying may result in a penalty, delaying eligibility. Planning early gives you more options and avoids the stress of last-minute decision-making.
How Surprenant, Beneski & Nunes Can Help
At Surprenant, Beneski & Nunes, we work with Massachusetts families to design estate and Medicaid plans that protect both assets and loved ones. Whether you are worried about a parent needing nursing care or you are planning ahead for your own future, we will explain your options and build a plan tailored to your needs. With the right guidance, you can qualify for care without losing everything you’ve worked for.
Why Now Is the Time to Plan Ahead
Understanding which assets are exempt and which are countable under Massachusetts Medicaid rules is key to protecting your financial future. The sooner you plan, the more options you have to safeguard your home, savings, and family’s stability.
At Surprenant, Beneski & Nunes, we can guide you through Medicaid planning and estate strategies that fit your unique needs. Contact us today to schedule a consultation and take the first step toward peace of mind for you and your loved ones.
