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The Atlas · 2026

The Medicaid-planning
and long-term-care
playbook.

Every state. Every asset. Every option — in plain English. Built for families, not placement agencies.

Something just happened →We're planning ahead
Orientation and way-finding — a warm impressionist meadow with a faint path toward a cream horizon
All 50 states
CMP + elder-law aligned
Cited from state Medicaid manuals
Not legal advice
Editorially independent
No email wall
Where to start

Six paths through
the same maze.

Most families enter ElderCareAtlas through one of these six doors. Pick the one that matches where you are right now — you'll find the others linked from inside.

◆Start here

Medicaid Planning

How Medicaid long-term-care eligibility actually works — assets, income, and the planning strategies that survive the lookback.

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◇The rule

5-Year Lookback

Every transfer in the 60 months before you apply is on the table. The lookback, the penalty divisor, and the safe-harbor exceptions.

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◉The numbers

Long-Term Care Costs

What nursing homes, assisted living, and home care actually cost in your state. The numbers that drive the penalty divisor.

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◎For couples

Community Spouse

CSRA, MMMNA, and the Snapshot Date. How the non-applicant spouse keeps a home, a car, a retirement account, and a monthly income.

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◈For veterans

Veteran Aid & Attendance

Up to $2,727/month (2026) for wartime veterans and surviving spouses who need help with activities of daily living.

Read →
◐Something just happened

Crisis Playbook

First 30 days after a stroke, fall, or dementia diagnosis. What to do, in what order, to preserve options and assets.

Read →
The Signature Column

If your parent just entered a nursing home,
the clock already started.

Medicaid planning is the one area of elder law where doing nothing costs you the most. Every week of delay is a week of private-pay burn against a $10,000-a-month bill, and every financial decision made in panic lives inside the next Medicaid application's 60-month review window.

Families walk into this problem in two modes: planning-ahead or already-in-crisis. The strategies are different. The timelines are different. The math is different. The worst outcomes cluster in the middle ground — where a family half-plans, pays down assets in the wrong order, gifts to the wrong person, or transfers a home the wrong way.

ElderCareAtlas is organized around the two modes and the six levers that matter in both: Medicaid eligibility, the 5-year lookback, the community spouse's protections, long-term-care cost geography, VA benefits stacking, and estate recovery exposure. Every page cites its state Medicaid manual or the federal regulation behind it. Every dollar figure is the current figure, not an aggregated national median.

We do not take placement-agency referrals. We do not list attorneys who pay for listings. When we recommend calling a Certified Medicaid Planner or an elder-law attorney, it's because the situation actually warrants it — and we'll tell you when it doesn't.

Filed underMedicaid planning →Crisis playbook →The lookback →
Answered

What is ElderCareAtlas for?

ElderCareAtlas is the state-by-state reference for families making Medicaid-planning, long-term-care, and elder-law decisions. Every page cites the state Medicaid manual or federal regulation behind the rule, every dollar figure is current, and the editorial is independent of placement agencies and attorney referral networks.

The 5-year lookback is a federal Medicaid rule that reviews every financial transfer you made in the 60 months before applying for long-term-care Medicaid. Uncompensated gifts, below-market sales, and transfers to trusts inside that window create a penalty period of ineligibility — even if you're otherwise qualified.
A primary residence is an exempt asset while you live there, while a spouse lives there, or while a minor, blind, or disabled child lives there. But Medicaid Estate Recovery can place a claim against the home after you die in most states. Protection strategies exist — they depend on your state, your home equity, and timing relative to the 5-year lookback.
Private-pay nursing home cost ranges from about $7,200/month in Louisiana to over $15,000/month in Alaska and Connecticut. The national median for a semi-private room in 2026 is around $9,800/month — roughly $117,600/year. These figures drive each state's Medicaid penalty divisor.
No — not without triggering the 5-year lookback penalty. Any gift inside the 60-month window produces a penalty period calculated by dividing the gift amount by your state's penalty divisor. The planning strategies that actually work (caregiver agreements, irrevocable trusts, spend-down on exempt assets) require specific structure and timing.
For straightforward spend-down (one asset, one state, no gifts in the last 5 years) a Certified Medicaid Planner is often enough and costs less. For anything involving a home transfer, a trust, a community spouse, a disabled child, or a crisis where the applicant is already in a facility — use an elder-law attorney. The dollar stakes typically justify the legal fee by 10x.
Start the right way

Pick your state.
Read your lookback.
Then call a planner.

Most families waste $30–60k by acting before they understand the framework. Twenty minutes in the Atlas saves months of backtracking.

Find my state →Find a planner
Avg nursing-home cost$9,800/mo1Semi-private room · US median · 2026
Federal lookback window60 months2Every transfer. Every state. No exceptions below the federal floor.

Sources

  1. Cost of Care Survey — Genworth Financial · US semi-private nursing-home median, 2026
  2. 42 U.S.C. § 1396p — Liens, Adjustments, and Transfers of Assets — Cornell Law School — Legal Information Institute · § 1396p(c)(1)(B)(i) — 60-month lookback