Can Medicaid Take Your House in Ohio: Liens, Waivers, and Exemptions

Yes, Medicaid can take your house in Ohio, but only after the recipient dies and only if no protected family member stands in the way. Ohio’s estate recovery program uses a broad definition of “estate” that reaches past probate, so retitling the home into a living trust or adding a joint owner will not, by itself, shield it. The state cannot recover while a surviving spouse is alive, and several other exemptions apply when specific family members survive or live in the home.

When Ohio Can Recover Against the Home

Federal law requires every state to seek repayment for certain Medicaid benefits after a recipient dies.¹ Ohio’s program, run by the Attorney General’s Office for the Department of Medicaid, targets two groups: anyone who was permanently institutionalized (in a nursing facility or other medical institution and not expected to return home) and anyone who received Medicaid benefits at age 55 or older, whether or not they lived in a facility.²

The recoverable benefits include nursing facility care, home and community-based services, and related hospital and prescription drug costs. After decades of care, the claim against an estate can easily reach six figures. The state recovers only what Medicaid actually paid, without interest or penalties, and if the estate is worth less than the claim, Ohio takes what is there and writes off the rest.

Living Trusts and Joint Ownership Do Not Protect the House

A common assumption is that keeping the home out of probate keeps it out of Medicaid’s reach. That is not how Ohio’s law works. The recoverable estate includes all real and personal property in which the recipient held any legal title or interest at death, including assets that pass through joint tenancy, tenancy in common, survivorship, life estate, a living trust, or any similar arrangement.³

A house in a revocable living trust is still reachable. So is a house titled with a transfer-on-death designation, or one jointly owned with an adult child. The state recovers to the extent of the recipient’s interest, so a half-interest in a jointly held home exposes that half. Restructuring the title alone does not remove the home from the recovery calculation.

Family Members Who Block Recovery

Ohio law stops estate recovery entirely when certain relatives survive the recipient or live in the home. The strongest protection belongs to a surviving spouse. No recovery can occur while the spouse is alive.⁴ This is a complete bar rather than a deferral, though the state can later pursue property the spouse inherited from the Medicaid recipient when the spouse dies.

Recovery is also blocked if the recipient leaves behind a child who is under 21 or who is blind or permanently and totally disabled, regardless of the child’s age.⁴ These children do not need to live in the home. Their survival alone stops recovery.

The Sibling Exemption

Recovery cannot proceed against the home while a sibling of a permanently institutionalized recipient lawfully lives there, provided the sibling lived in the home for at least one year immediately before the recipient entered the facility and has lived there continuously since.⁴ This one applies only to recipients who were permanently institutionalized, not to the broader 55-and-older group.

The Caretaker Child Exemption

One of the most valuable protections is often missed. Ohio delays recovery against the home while an adult son or daughter of a permanently institutionalized recipient lives there, if that child provided care that delayed the parent’s institutionalization, lived in the home for at least two years immediately before the parent entered the facility, and has lived there continuously since.⁴

Documentation is where families stumble. The state expects a written statement of when the child moved in, a level-of-care assessment showing the parent would have entered a facility sooner without the child’s help, a physician’s statement about the type and duration of care needed, and records showing the child’s role in providing that care. Informal help without records rarely qualifies. If you are caring for a parent in their home now, start keeping the paper trail before it is needed.

Liens While the Recipient Is Still Alive

Estate recovery itself waits until death, but Ohio can place a lien on the real property of a living Medicaid recipient under federal TEFRA rules when the recipient is an inpatient in a nursing facility or other medical institution, is required to spend nearly all income on care, and has been determined unlikely to return home.⁵ Ohio’s statute cross-references this authority and permits recovery from the sale of the liened property.³

A TEFRA lien cannot attach if the recipient’s spouse, a child under 21 or blind or disabled child, or a sibling with an equity interest who lived in the home for at least a year before institutionalization lawfully lives there.⁵ If the recipient is discharged and returns home, the lien dissolves by law. The underlying Medicaid debt survives, and the estate remains subject to recovery after death.

The Hardship Waiver

The director of the Ohio Department of Medicaid can waive estate recovery when it would cause undue hardship to a survivor. Decisions are case by case, and the bar is high. The state looks for situations where recovery would leave a survivor unable to meet basic needs, not situations where losing an inheritance is merely inconvenient.⁴

Recognized examples include cases where the estate is the sole income-producing asset of the survivor, such as a family farm generating limited income, or where recovery would deprive a survivor of necessary food, shelter, or clothing. A waiver request should include detailed documentation of the survivor’s income, expenses, and lack of alternative resources.

Planning Ahead: What Actually Works, and What Backfires

The Five-Year Look-Back

Giving the house to a child before applying for Medicaid is one of the most damaging mistakes families make when it is not planned far enough in advance. When someone applies for long-term care Medicaid, Ohio reviews all asset transfers made during the 60 months before the application.⁶

Any transfer for less than fair market value during that window triggers a penalty period during which Medicaid will not pay for nursing facility care. The penalty is calculated by dividing the total value of the improper transfers by Ohio’s penalty divisor, currently $7,787 per month. A $155,740 gift produces roughly 20 months of ineligibility. Transferring a $200,000 home three years before applying can produce more than two years of ineligibility, and the penalty period does not begin until the applicant would otherwise qualify for Medicaid, meaning the applicant can be in a nursing facility with no way to pay. A transfer made more than five years before the application is outside the look-back and does not trigger a penalty.

Long-Term Care Partnership Policies

Ohio’s Long-Term Care Partnership Program, marketed as LTC4Me, lets you shield assets equal to what a qualifying long-term care insurance policy has paid in benefits. If your policy pays out $150,000 before it is exhausted, you can keep $150,000 in assets that would otherwise disqualify you from Medicaid, and those same assets stay protected from estate recovery. Policies must be bought well before care is needed, premiums are not cheap, and some assets that are not counted during eligibility, including special needs trusts, pooled trusts, and certain annuities, can still be subject to recovery.⁷

The Home Equity Cap

Before recovery is even on the table, home equity affects eligibility. In 2026, Ohio caps home equity for a single applicant at $752,000.⁸ Equity above that amount disqualifies the applicant from Medicaid-funded nursing facility or home-based care until the equity is reduced. The cap does not apply when a spouse, a child under 21, or a blind or disabled child lives in the home. The figure is adjusted annually. Below the cap, the home is exempt during the recipient’s lifetime, but it becomes a target for recovery after death.

After the Recipient Dies

Once the Medicaid recipient dies, the person responsible for the estate must notify the Ohio Attorney General’s Office if the decedent was permanently institutionalized or was 55 or older when receiving benefits.⁴ Skipping notice does not make the claim disappear. It just complicates the estate.

The AGO then files a claim against the estate for the cost of the Medicaid benefits paid.² Most probate claims against an Ohio estate must be presented within six months of the decedent’s death, though Medicaid claims follow a separate statutory timeline that may extend beyond that window.⁹

If the home is subject to recovery and no exemption applies, the estate usually has to sell the property to pay the claim. Heirs can pay the claim from other funds and keep the house, but that assumes the funds exist. Whether the answer for your family is a caretaker-child arrangement, a partnership policy, a well-timed transfer, or none of these, the decisions worth making are the ones made before a Medicaid application is on the table, not after.

1
Centers for Medicare & Medicaid Services. Estate Recovery
2
Ohio Department of Medicaid. Ohio Medicaid Estate Recovery
3
Ohio Legislative Service Commission. Ohio Code 5162 – Medicaid Estate Recovery Program
4
Ohio Legislative Service Commission. Rule 5160:1-2-07 – Medicaid: Estate Recovery
5
Office of the Law Revision Counsel. 42 USC 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets
6
Ohio Legislative Service Commission. Rule 5160:1-6-06 – Medicaid: Transfer of Assets
7
Ohio Department of Insurance. Partnership for Long-Term Care Insurance (LTC4Me)
8
Ohio Department of Medicaid. Medicaid Eligibility Procedure Letter No. 191 – 2026 COLA
9
Ohio Legislative Service Commission. Section 2117.06 – Presentment of Claims Against an Estate