If you’re juggling kids, a career and aging parents, you’re not alone. Roughly one in four U.S. adults is stuck in the “sandwich generation,” trying to hold it together. It’s a grind that drains your time, energy and wallet.
Between lost work hours and paying for things like adaptive devices or long-term care, the costs pile up fast. One study from the National Library of Medicine found that caring for an elderly parent can cost anywhere from $144,302 to $201,896 over a two-year period. (1)
Take Katie, for example. She’s caring for her 85-year-old mom, whose mental health is declining, and fears she’ll soon need to move into a nursing home. With nursing homes' costs topping $100,000 a year — and in-home care around $75,000 — Katie is worried how she’ll cover it all. (1)
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Katie's mom hopes to qualify for Medicaid, which covers nursing home and other long-term care costs that Medicare usually doesn't. But Medicaid is a means-tested program, meaning applicants can’t have more than $2,000 in countable assets or earn too much income. (2)
Katie is listed as a beneficiary on her mom's pension and retirement accounts. She wonders: will that help her mom qualify for Medicaid — and allow Katie to keep the money?
Joint ownership doesn’t protect assets
Even if Katie is a co-owner, those accounts are still considered her mother’s.
When the government reviews Medicaid eligibility, any jointly held accounts are counted unless there’s clear proof the funds don’t belong to the Medicaid applicant. For instance, if Katie and her mom have $20,000 in a joint account — even if Katie contributed $15,000 — Medicaid will assume the funds belong to both women equally unless Katie can prove otherwise with receipts and documentation. (3)
To qualify for Medicaid, Katie's mom would need to spend down those joint accounts before she can get coverage. If her pension income is too high, she also won't qualify — unless she uses that income to cover nursing home care and can show she can’t afford the full cost. (4)
If Katie's mom does qualify for Medicaid and still dies with assets remaining, Medicaid estate recovery rules may allow the state to reclaim some of the costs of her care. (5) Having Katie’s name on the account won’t protect that money. (6)
Medicaid is meant for people in genuine financial need, so the system includes safeguards to prevent people from hiding assets just to qualify. (7)
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Protecting assets — but plan early
There are ways to protect assets while still planning for Medicaid eligibility, but timing is everything. Medicaid has a five-year “lookback” period to prevent applicants from transferring assets or income to qualify unfairly. (8)
That means if you give away or transfer assets to children, beneficiaries or a trust within five years of applying for Medicaid, you could face a penalty period before becoming eligible.
The key is to plan well in advance. An estate planning attorney can help navigate the process and ensure transfers comply with Medicaid rules.
For example, if Katie’s mom had transferred assets decades earlier — say, when she was in her 50s — to help Katie buy a home, she could have protected that portion. If her name wasn’t on the property deed, it wouldn’t have been counted as part of her assets later on.
Should adult children and aging parents share accounts?
Even though adding children as beneficiaries or co-owners doesn't help with Medicaid planning, it can still make sense for other reasons.
If Katie's mom became incapacitated or died, Katie could access the funds to pay bills without waiting for court approval to become her guardian or executor. Shared access can also help adult children monitor accounts for fraud or scams — a growing concern for older adults, totalling $20.3 billion each year. (9)
While it may be too late for Katie’s family to pre-plan for Medicaid coverage, she still has options. Her mom can spend down assets to pay for care until she qualifies. For others, the lesson is clear: don’t wait. Talking with an estate planning lawyer now can help protect your family’s assets and prevent costly complications later.
Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
National Library of Science (1); American Council on Aging (2); Medicaid Long-Term Care (3); National Council on Aging (4, 6); Elder Needs Law (5); Marketwatch (7); Medicaid Planning Assistance (8); Where You Live Matters (9).
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Christy Bieber has 15 years of experience as a personal finance and legal writer. She has written for many publications including Forbes, Kilplinger, CNN, WSJ, Credit Karma, Insurify and more.
