Can You Qualify for Medicaid If You Own a Home in North Carolina?

Think owning a home means you can’t qualify for Medicaid? Think again.

The truth is, you can qualify for Medicaid in North Carolina even if you own a home. As of 2025, your primary residence is generally exempt from Medicaid’s asset limit if you intend to return to it or if your spouse, a child under 21, or a disabled person lives there.

However, single applicants have a home equity interest limit of $730,000.

At The Trusts and Estates Law Group, we’ve helped North Carolina families secure care while protecting their most valuable assets.

Medicaid and Your Home in North Carolina

Medicaid has strict income and asset limits, but your primary residence is often treated differently. While not entirely exempt, your home is protected under certain conditions. Let’s examine the factors involved.

Primary Residence Exemption

Medicaid typically considers your primary residence—the place you live most of the time—as an exempt asset. Here’s how this works:

•       If you are temporarily in a nursing home but intend to return to your house, it can still count as your primary residence.
•       If your spouse, a child under 21, or a disabled individual resides in the home, it remains exempt from Medicaid’s asset calculations.

This exemption ensures that needing Medicaid doesn’t mean losing your home immediately; however, there are limits and conditions you need to keep in mind.

Equity Limit

Even though your primary residence is often exempt, its equity can play a role. Equity is the home’s market value minus any outstanding mortgages or liens. For 2025, the equity limit in North Carolina is $730,000.

If your equity exceeds this limit, Medicaid will consider the excess a countable asset; however, exceptions apply, such as when a spouse or dependent relative continues living in the home.

For example, imagine an applicant whose home equity is $800,000 but has a spouse residing there. In this case, the equity limit doesn’t apply, ensuring the spouse’s housing stability.

Important Considerations for Medicaid Eligibility

Owning a home is just one part of Medicaid eligibility. Let’s explore the other factors you need to understand.

Asset Limits

Medicaid imposes strict limits on countable assets. As of 2025, here’s what you should know:

•     Single applicants: $2,000
•     Married couples (both applying): $3,000
•     Married couples (one applying): $2,000 for the applicant, up to $157,920 for the non-applicant spouse

This structure allows a non-applicant spouse to retain a significant portion of the couple’s assets, ensuring their financial security while the applicant receives care.

Medicaid Estate Recovery Program

North Carolina has a Medicaid Estate Recovery Program. This program allows Medicaid to seek reimbursement for care costs from the estate after the Medicaid recipient passes away.

The home, even if exempt during the recipient’s lifetime, can be subject to recovery after death. Understanding this program is crucial for families wishing to preserve generational wealth.

Planning Ahead to Protect Your Home

You can protect your home and other assets with thoughtful planning before applying for Medicaid.

Medicaid Asset Protection Trusts

One option is creating a Medicaid Asset Protection Trust. By transferring your home into this trust, you relinquish ownership but shield it from being counted as an asset for Medicaid purposes. This trust must be created well in advance due to Medicaid’s look-back rules.

60-Month Look-Back Period

Medicaid has a five-year look-back period, during which any asset transfers for less than fair market value trigger penalties. This includes gifting your home or selling it at a reduced price.

If you’re considering transferring ownership, it’s essential to plan ahead. Transactions made within this five-year window could affect your Medicaid eligibility.

Child Caregiver and Sibling Exemptions

Medicaid also provides exemptions for specific circumstances. For example:

•     Child Caregiver Exemption: If an adult child has lived in your home for at least two years and provided full-time care, the home may be exempt.
•     Sibling Exemption: If a sibling has equity in the home and has lived there for at least one year, they may qualify for an exemption.

Consult an Attorney

The rules surrounding Medicaid and homeownership are complex. Speaking with an elder law attorney who understands Medicaid planning can provide a clear roadmap. They’ll assess your specific situation and recommend strategies to protect your assets.

Get Help with Medicaid Planning in North Carolina: Contact The Trusts and Estates Law Group

At The Trusts and Estates Law Group, we have extensive experience helping North Carolina residents understand Medicaid rules and plan for the future. Whether you’re applying for Medicaid or planning years in advance, our firm can guide you every step of the way.

Call us at (919) 782-3500 to schedule a consultation. Together, we can help you secure the care you need without sacrificing your home or your family’s financial stability.