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Imo 2 different issues, first
the month of the Act of Sale the $ is “income”.
The following month and thereafter it’s “assets”. The sale price is known in some way so traceable to the penny, so eventually state will know. Either by a search of the database by Medicaid caseworker or when you renew Medicaid and disclose the sale,

I’m assuming that your on community based Medicaid as it makes imho no sense to buy a new house if it’s LTC Medicaid in a NH. It is community based Medicaid that you are on, right?

In theory, your supposed to contact MEDICAID when your status changes for income and assets that takes you over allowed maximum for your states regulations. What the maximum $ is and what timeframe required will be on your states Medicaid info website or ask your caseworker.

But, It kinda seems if you buy another house within short order and it’s a lateral purchase, that it’s ok for Medicaid. Medicaid cannot force you to stay at old 2 story House #1. If you can sell it and move into a newer, 1 story & more easy to get around house #2, then it makes sense to do.

So say House #1 sells for 100k & new house #2 is bought for 100k (lateral purchase) it’s ok. Or even if costs more like 125k so you now have a 25k mortgage on House #2, its ok.

But if you sell house #1 for 100k and then buy a new house for 75k, so have 25k in income initially and then 25k in assets afterwards, that could be an issue for Medicaid. You need to contact your caseworker to see if the extra assets / $ will be a problem. Your likely to find that to make this easier, buy a place that just a lil bit more than what you sold the old place for. So it used all the $ from Act of Sale and you needed to get a little mortgage or loan to buy it.

again please speak both your caseworker before you do this. You don’t want to jeopardize your eligibility or put yourself in paperwork he’ll from something that can be avoided.

Part 2, depending on your age when you went onto community based Medicaid (like over age 55) and what state you live in (TIFRA states) there might be a lien on the property. In some states, Medicaid can place a lien to offset $ paid for community based care. You need to clearly ask the Realtor about if this is an issue for your state & ask this ahead of selling your home.
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