All people wait for that red-letter day when they make their final mortgage payment. They look forward to owning their home without encumbrances. As long as property taxes are paid, their most valuable asset is safe. The property can be passed on to their heirs.

But let us not forget the Medicaid reimbursement official with a lien, ready to seize your treasured asset. Under the laws of most states they have the right to seek reimbursement for Medicaid payments. As long as you live in your home it is exempt from recovery. The moment you enter a nursing home, that protection is gone.

If you are married, your house will be exempted as long as your spouse lives in it. But if the spouse dies, the state can place a lien on your home. Then you can neither sell it nor refinance it without reimbursing the state for your Medicaid payments. If a situation arises where what you owe equals the equity in your house, your heirs will receive nothing from the sale of your home. To avoid such a situation, the following safeguards can be taken.

• Obtain long term care insurance. It pays for in-home care like a stay in a nursing home or assisted living facility, so that Medicaid need not be resorted to. Statistics reveal that 69 percent of Americans who reach 65 will need long term care at some stage.

• Gift your home to your children or loved ones. A lien cannot be imposed by the state on a home which is not yours. The gift has to be made more than 60 months before you enter a long term care facility. The recipient might have tax implications.

• Your home can be transferred with a special power of appointment. The transfer could become effective immediately or after you die. If this is done, the state is kept away.

• Consult an attorney who specializes in elder law.