Estimate how far your countable assets must drop to qualify for long-term-care Medicaid — and the penalty period a gift within the 5-year look-back creates in your state.
⚖Educational estimate only — not legal or financial advice. Medicaid rules are state-specific and change often. Consult a certified elder-law attorney before transferring assets or applying.
Your Situation
Sets the asset limit and penalty divisor.
Cash, accounts, investments, extra property. Home, one car & belongings are usually exempt.
Gifts & Transfers (Look-Back)
Used to estimate the out-of-pocket cost of any penalty period.
Your Estimate
Countable assets to spend down
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Choose a state and enter your countable assets.
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Asset limit
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Protected (limit + CSRA)
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Penalty period
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Penalty ends ~
How your assets break down
spend-down = countable − asset limit − CSRA
Look-back transfer penalty
penalty months = gift ÷ state divisorlook-back = 60 months
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State penalty divisor / mo
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Months of ineligibility
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Out-of-pocket during penalty
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Penalty ends ~
Gift now vs. no gift
With this gift
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months ineligible
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No gift
0
months ineligible
$0 penalty
Community Spouse Resource Allowance (CSRA)
When one spouse enters care, the healthy “community” spouse can keep the CSRA. In 2026 that is between $32,532 and $162,660. Only assets above the CSRA plus the applicant’s allowance must be spent down.
Single vs. married — same assets
If single
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to spend down
No spousal protection
If married (one applying)
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to spend down
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Your protected spousal amount
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The community spouse keeps roughly half of countable assets, bounded by the 2026 federal minimum and maximum. Some states protect up to the maximum regardless of the split.
Also protected for the spouse
A minimum monthly maintenance needs allowance (MMMNA) shifts some of the applicant’s income to a low-income community spouse, and the family home is generally exempt while the spouse lives there. An elder-law attorney can often protect more.
For most families, long-term nursing-home care is the single largest expense they will ever face — and Medicaid is the only realistic way to pay for an extended stay.
Choose your state and whether the applicant is single or married with one spouse applying. Your state sets both the countable-asset limit and the penalty divisor used for gifts, so the numbers change as you switch states.
2
Enter your countable assets
Enter the total of your countable (non-exempt) assets — cash, bank and brokerage accounts, CDs, and any second property or extra vehicles. Your primary home up to an equity limit, one car, and personal belongings are usually exempt, so leave those out.
3
Add any gifts made in the last five years
If you gave money or property away, or sold something for less than it was worth, enter the amount and the date. Only transfers inside the 60-month look-back count toward a penalty — the calculator excludes older ones automatically.
4
Read your spend-down and any penalty
The headline shows how much countable value must be spent down to reach your state's limit. The Look-Back Penalty tab turns any gift into months of ineligibility and an out-of-pocket cost, with an approximate end date.
5
See how a spouse changes it
Open the Married (Spousal Protection) tab to compare single vs. married. The Community Spouse Resource Allowance (CSRA) protects a large share of assets for the healthy spouse, often cutting the spend-down dramatically.
Countable assets above your state's limit must be spent down. For a married applicant, the Community Spouse Resource Allowance (CSRA) is subtracted first. The asset limit is typically $2,000, with higher limits in states such as New York, Illinois, and California ($130,000 through June 30, 2027 for covered programs).
Community Spouse Resource Allowance (CSRA)
CSRA = clamp(50% or 100% × countable assets, $32,532, $162,660)
In most states the healthy spouse keeps about half of the couple's countable assets, bounded by the 2026 federal minimum ($32,532) and maximum ($162,660). "100% states" (such as Florida, Georgia, and Illinois) instead let the community spouse keep 100% of countable assets up to the maximum, and a few states raise the minimum (Connecticut, Wisconsin, Washington, New York) or lower the maximum (Illinois, South Carolina). This calculator applies each state's rule.
Look-back penalty
penalty months = gift amount ÷ state penalty divisor
Gifts inside the 60-month look-back are divided by the state's penalty divisor (its average monthly private-pay nursing-home cost) to produce months of ineligibility. The penalty starts once you are otherwise eligible and in care, not when the gift was made.
Reviewer: Calculover Editorial Review - Elder-law source and limitation review
Last reviewed: 2026-08-11
Last verified: 2026-08-11
Data effective: 2026-01-01
Methodology
Spend-down = countable assets − state asset limit − Community Spouse Resource Allowance (CSRA) for a married applicant. The CSRA is modeled per state as either 50% or 100% of countable assets, bounded by the CMS 2026 minimum ($32,532) and maximum ($162,660), with state-specific minimum/maximum overrides where they apply. Penalty period = disqualifying gifts within the applicable state look-back divided by the state's penalty divisor (average monthly private-pay nursing-home cost); states publishing a daily divisor are converted at 30.4167 days per month. Asset limits default to $2,000, with verified exceptions for a subset of states. California uses its current $130,000 one-person asset limit and staged 2026 long-term-care transfer review. Un-seeded states use a national-average default divisor, clearly labeled.
Assumption: Countable-asset figures are entered by the user; the tool does not verify balances or distinguish exempt from non-exempt assets on your behalf.
Assumption: The CSRA is applied per state: most use the federal 50%-of-assets model, while "100% states" let the community spouse keep up to the maximum, and a few states raise the minimum or lower the maximum.
Assumption: The penalty period is assumed to begin at the application/reference date, which approximates the real rule that it starts only once the applicant is otherwise eligible and in care.
Limitations & guidance
State asset limits, CSRA figures, income limits, and penalty divisors change over time and vary in ways a single tool cannot fully capture — several states set divisors by region, county, or facility.
The tool does not model exempt-asset rules, annuities, trusts, promissory notes, caregiver agreements, estate recovery, or income (Miller) trusts, all of which materially affect real cases.
California restored asset testing for covered programs on January 1, 2026, with a $130,000 one-person limit through June 30, 2027 and a staged long-term-care transfer review. A few other states and DC also set asset limits above $2,000. Confirm your state's current rules before acting.
Professional guidance: This calculator is for educational and planning purposes only and is not legal, financial, tax, or medical advice. Medicaid eligibility and asset-transfer rules are complex, state-specific, and change frequently. Consult a certified elder-law attorney or an accredited Medicaid planner before spending down assets, making any gift or transfer, or submitting an application.
Countable vs. exempt assets ↗Countable assets (cash, accounts, investments, extra property) must be spent down to the limit. Exempt assets — your primary home to an equity limit, one car, household goods, a small burial fund — do not count.
Asset limit ↗The maximum countable assets an applicant may keep and still qualify. It is typically about $2,000 for a single applicant, though a few states set higher figures; California's covered programs use a $130,000 one-person limit through June 30, 2027.
Spend-down ↗The process of reducing countable assets to the state limit by paying for care, medical bills, or other allowable expenses so you become financially eligible for Medicaid.
Look-back period ↗The 60 months (5 years) of financial history a state reviews when you apply. Gifts or below-market transfers made in this window can create a penalty; older transfers do not.
Penalty divisor ↗A dollar figure set by each state — roughly its average monthly private-pay nursing-home cost — used to convert disqualifying gifts into months of ineligibility.
Penalty period ↗The span of Medicaid ineligibility created by transfers in the look-back. It equals total gifts divided by the penalty divisor and begins only once you would otherwise qualify and are receiving care.
CSRA (Community Spouse Resource Allowance) ↗The amount of countable assets the healthy, at-home (community) spouse may keep when the other spouse needs long-term care. In 2026 it ranges from $32,532 to $162,660.
MMMNA (Minimum Monthly Maintenance Needs Allowance) ↗The minimum monthly income the community spouse is allowed to keep. If the healthy spouse's own income is low, some of the applicant's income is shifted to them.
Transfer for less than fair market value ↗Giving away money or property, or selling it for below its worth, during the look-back. Such transfers are added together and divided by the penalty divisor to compute the penalty.
Estate recovery ↗After a Medicaid recipient's death, states must try to recover what they paid for long-term care from the person's estate — often the home. Planning ahead with an attorney can reduce this exposure.
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Scenarios
Real-World Examples
3 worked examples▸
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Single applicant in Florida
Nursing-home Medicaid, no spouse
State / status Florida · Single · $120,000 countable
Spend-down = $120,000 − $2,000 = $118,000. Nearly all countable assets must be spent on care or other allowable costs before Medicaid begins. The home, one car, and belongings stay exempt.
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Married couple, one spouse applying
CSRA protects the healthy spouse
State / status Florida · Married · $120,000 countable
Florida is a "100% state": the community spouse can keep 100% of countable assets, up to the 2026 maximum of $162,660. That protects the full $120,000, so spend-down = $120,000 − $2,000 − $120,000 = $0 — the couple qualifies without spending down countable assets. In a "50% state" like Pennsylvania, the spouse would keep $60,000 and the spend-down would be $58,000.
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A gift inside the look-back
$60,000 gift to a child, Florida
Gift $60,000 given 18 months ago
Florida's 2026 penalty divisor is $10,645. $60,000 ÷ $10,645 ≈ 5.6 months of ineligibility — roughly $60,000 of care you would private-pay. Because the gift is inside the 5-year window, it counts; a gift made six years ago would not.
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Reference
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Deep Dive
Medicaid Spend-Down and the 5-Year Look-Back, Explained
For most families, long-term nursing-home care is the single largest expense they will ever face — and Medicaid is the only realistic way to pay for an extended stay. Qualifying means passing an asset test, which usually requires "spending down" savings, and surviving a five-year look-back at any gifts. This guide explains how the spend-down figure and the penalty period are calculated, and why the spousal allowance matters so much.
How the spend-down is calculated
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Long-term-care Medicaid limits how much a person can keep in countable assets — cash, bank and investment accounts, CDs, and property beyond the home. In most states the limit is about $2,000 for a single applicant, though a handful set it higher. California restored asset testing for covered programs on January 1, 2026, with a $130,000 one-person limit through June 30, 2027. Your spend-down is simply the countable amount above that limit: assets of $120,000 in a $2,000 state means spending down $118,000 before Medicaid pays. Crucially, spending down does not mean giving money away — it means paying for care, medical costs, home repairs, or other allowable expenses. Exempt assets (your home to an equity limit, one car, personal belongings, a modest burial fund) are not counted and do not need to be spent.
The 5-year look-back and the penalty divisor
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When you apply, the state examines the previous 60 months of financial records for gifts or assets sold below fair value. Each disqualifying transfer is added up and divided by the state's penalty divisor — a figure close to the average monthly private-pay nursing-home cost in that state. A $60,000 gift in a state with a $10,645 divisor creates about 5.6 months of ineligibility. The penalty does not begin when you make the gift; it starts only once you are otherwise eligible and actually receiving care, which means you must private-pay through the entire penalty. That timing is what makes a well-intentioned gift to a grandchild so financially dangerous, and why transfers should never be made to qualify without professional advice.
How the spousal allowance protects a healthy spouse
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When only one spouse needs care, federal spousal-impoverishment rules protect the other. The Community Spouse Resource Allowance (CSRA) lets the at-home spouse keep roughly half of the couple's countable assets, bounded in 2026 between $32,532 and $162,660. A married couple with $120,000 in countable assets can protect $60,000 for the community spouse, cutting the spend-down from $118,000 (if single) to $58,000. Some states are "100% states" that let the community spouse keep up to the maximum regardless of the split. Combined with the minimum monthly maintenance needs allowance for income and the home exemption while a spouse lives there, careful planning can preserve far more than families expect.
Why this is a job for an elder-law attorney
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This calculator gives an educational estimate, not a plan. Real cases involve exempt-asset rules, annuities, promissory notes, caregiver agreements, trusts, and estate-recovery exposure that vary by state and change frequently. A certified elder-law attorney or an accredited Medicaid planner can often protect significantly more assets — legally — than a do-it-yourself spend-down, and can avoid the penalty traps that come from an ill-timed gift. Use the numbers here to understand the shape of the problem, then get advice specific to your state and situation before you move any money.
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Questions
Frequently Asked Questions
8 questions▸
What counts as a countable asset for Medicaid?+
Countable (non-exempt) assets include cash, bank and brokerage accounts, CDs, stocks, bonds, a second home, and extra vehicles. Your primary home up to an equity limit, one car, household goods, and a small burial fund are usually exempt. Only countable assets must be spent down to the limit — typically about $2,000 for a single applicant.
What is the Medicaid 5-year look-back?+
When you apply for long-term-care Medicaid, the state reviews the past 60 months (5 years) of financial records for gifts or assets sold for less than fair market value. Transfers inside that window can trigger a penalty period; transfers made earlier do not.
How is the Medicaid penalty period calculated?+
The total of disqualifying gifts is divided by your state's penalty divisor (its average monthly private-pay nursing-home cost). The result is the number of months you are ineligible. For example, a $60,000 gift in a state with a $10,645 divisor creates about 5.6 months of ineligibility.
Can my spouse keep our assets if I need Medicaid?+
Yes. When one spouse enters care, the community (healthy) spouse can keep the Community Spouse Resource Allowance (CSRA). In 2026 that is between $32,532 and $162,660, depending on the couple's assets and the state. Only assets above the CSRA plus the applicant's small allowance must be spent down.
Does giving money to my kids trigger a penalty?+
It can. Any gift or below-market transfer inside the 60-month look-back is added up and divided by the penalty divisor to create months of ineligibility. Transfers made more than five years before you apply are not counted. Never make transfers to qualify without first consulting a certified elder-law attorney.
Which assets are exempt from Medicaid spend-down?+
Commonly exempt assets include your primary residence up to a home-equity limit (often waived if a spouse lives there), one vehicle, household goods and personal effects, a modest prepaid burial or a small burial fund, and certain term life insurance. Rules vary by state, so confirm before counting anything as exempt.
When does the Medicaid penalty period start?+
The penalty period does not start when the gift is made. It begins only once you are otherwise eligible — assets spent down and receiving a covered level of care — and would normally qualify for Medicaid. That timing can make a penalty especially costly, because you must private-pay during the penalty months.
Should I plan a Medicaid spend-down myself?+
No. This calculator is an educational estimate only. Medicaid rules are state-specific and change often, and a wrong transfer can create months of ineligibility. Work with a certified elder-law attorney or accredited Medicaid planner before spending down assets or making any transfer.
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Bonus
2026 asset limits & penalty divisors — seeded states
Individual countable-asset limits and monthly penalty divisors for a sample of states, verified against the American Council on Aging's 2026 figures. States not listed use the standard $2,000 asset limit and a national-average default divisor in this tool — confirm your own state's divisor with its Medicaid agency.
State
Individual asset limit
Penalty divisor / month
Florida
$2,000
$10,645
Texas
$2,000
$7,339
Pennsylvania
$2,000
$12,811.50
Ohio
$2,000
$7,787
Georgia
$2,000
$11,122
Michigan
$2,000
$12,216.30
North Carolina
$2,000
$10,904
New York
$32,396
$13,765–$15,675 (by region)
Illinois
$17,500
Varies by facility
California
$130,000 through 6/30/2027
Staged LTC review in 2026
CSRA (2026): $32,532 minimum to $162,660 maximum. Federal look-back default: 60 months; California's LTC review is staged from 2026 toward 30 months. Figures change annually — last verified August 2026.