Long-term care · For families

Medicaid and the Family Home in Washington

While your parent is alive, the house is usually protected

For Apple Health long-term care, the home is generally an exempt asset: it does not count toward the $2,000 asset limit for a single person. That stays true after your parent moves into a nursing home, adult family home or assisted living, as long as they intend to return home, or a spouse or dependent relative lives there. The house does not have to be sold for your parent to qualify.

There is a ceiling. For nursing home and COPES coverage, home equity above $1,130,000 (2026) makes the applicant ineligible unless a spouse, or a child who is under 21, blind or disabled, lives in the home. Equity is the value of your parent's share minus the mortgage and other debts on it, so an accurate, documented value matters when the house is close to the limit.

If the house sits empty

Keeping the house exempt does not keep it free. Property taxes, insurance, utilities and upkeep still have to be paid, and a vacant house may need different insurance; call the insurer once no one is living there.

If your parent lives in a medical facility and is not reasonably expected to return home, DSHS can place a lien on the house before death. It will not file one if a spouse, state-registered domestic partner, child under 21 or sibling lives there, and it releases the lien if your parent returns home. If the house is sold, DSHS recovers its costs from the proceeds.

If the house is sold

A sale at fair market value is not a penalized transfer, but the money it brings in is no longer exempt. The net proceeds count toward the $2,000 asset limit, so they are generally spent on your parent's care before Apple Health pays. That can be a deliberate plan: private-pay choice first, Medicaid later if it is needed.

A sale to a family member for less than the house is worth is treated as a partial gift (see the next section). An independent appraisal is the usual way to document that the price was fair.

Giving the house to family

Apple Health looks back 60 months. A gift of the house, adding a child to the title, or a sale to family below fair value within 60 months before applying can cause a penalty period: months when Medicaid will not pay for long-term care. A child who receives the house as a gift also loses the stepped-up tax basis they would get by inheriting it.

Washington's rule allows a home to go, without a penalty, to the person's spouse; to a child under 21; to a child who meets the disability criteria; to a brother or sister who has an equity interest in the home and lived there for at least a year immediately before the parent needed institutional care; or to a son or daughter who lived in the home for at least two years and provided care, documented, that let the parent stay at home rather than move into care. Each exception has conditions; have an elder law attorney confirm one applies before any deed is signed.

If one spouse needs care and the other stays home

The home stays exempt while the spouse lives in it, and the home equity limit does not apply. The spouse at home may also keep a share of the couple's other assets, the Community Spouse Resource Allowance (up to $162,660 in 2026), plus a minimum monthly income. These rules exist so the healthy spouse is not impoverished by the other's care.

A transfer of the house to the spouse is also allowed without a penalty. How the couple holds title, and what happens to the house after both die, are worth settling with an elder law attorney early.

After death: estate recovery

Washington seeks to recover what it paid for federally funded long-term services and supports received at age 55 or older, and state-funded services at any age, from the person's estate. That reaches the house, bank accounts and other property, including non-probate assets such as a house passing by transfer on death deed, and life estates. It is why the personal representative's notice to creditors goes to DSHS.

Recovery is deferred while the person's spouse survives, or a child under 21, or a child who is blind or disabled. DSHS can also grant an undue hardship waiver, for example when recovery would cost an heir housing they cannot replace, or when the property is an heir's only income-producing asset.

Families can ask the DSHS Office of Financial Recovery about a specific estate at 800-562-6114.

Checklist

1. Write down whether your parent intends to return home, and who, if anyone, lives in the house now.
2. Keep paying the property taxes, insurance and utilities, and tell the insurer if the house will be empty.
3. Get a documented value if the equity may be near the limit, or before any sale to family.
4. Do not gift the house, add a child to the title, or sell it to family below value without advice from an elder law attorney.
5. If the house will be sold, plan how the proceeds will pay for care and when to apply.
6. After a death, expect DSHS to receive the notice to creditors, and ask the Office of Financial Recovery about deferral or a hardship waiver if they may apply.

Related guides

• Medicaid and Long-Term Care in Washington
• Selling a Parent's House to Pay for Care
• Powers of Attorney and the House
• If a Parent Can't Go Home: What Happens to the House
• Estate recovery in the probate glossary