1. Medicaid eligibility is determined solely based on Medicaid rules, not IRS gifting rules, so gifts can create periods of Medicaid ineligibility. 2. Prenuptial agreements do not impact Medicaid eligibility determination, as each spouse's assets are generally available for the other spouse's nursing home costs. 3. Long-term care insurance can benefit some by allowing them to keep more assets and still qualify for Medicaid, such as a woman who was able to protect $202,000 of her $300,000 by purchasing a $200,000 long-term care policy.