My aunt has no children, she has 2 accounts set up for me and a sibling. When she dies, I get $250,00 and he gets $250,00. The accounts have her name and my name on one. The other account has her name and his name.

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Mpint - with Auntie having 500k in assets in her name plus some sort of monthly income as well (like SS, other retirement income) and possibly other assets (stocks, annuity, whole lfe insurance policy), Auntie is going to have way way WAY too much assets to ever qualify for Medicaid in the near future.

Medicaid is a needs based entitlement which for NH Medicaid has eligibility at basically impoverishment with 2k max in nonexempt assets and their income under whatever her state has set for monthly income limit. Most have income under $ 2,100 mo.

FFs math is solid. Auntie would likely need over 4 years private pay at a NH before Medicaid is even on the horizon. Avg stay in a NH is under 3 years. Probability is she will die before spending down all that 500large. If her name is on the accounts, it's her assets. Medicaid tends to view all joint account as the elders assets.... You would have to prove all was your own $ & income that built that 250k.Ditto for your brother.

Upside is that Auntie will be able to pretty well afford any NH and with all sorts of amenities. She is a most fortunate elder. There is no downside for her. Now for you & bro, maybe just maybe there could be a small inheiriance.

Doing anything to gift, shift or transfer any of that 500k now means that Auntie cannot qualify for Medicaid till Feb 2022 without some sort of penalty or placing her assets into a medicaid compliant trust. If auntie is close to needing a NH, there isn't time to plan & shift assets to others. If she's still healthy & competent and not likely needing a NH for years, she should speak with an naela level elder law atty to discuss what options might be feasible to do things to benefit her & her needs & perhaps provide for heirs.
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I have a feeling that Medicaid would want your Aunt to spend down the $500k for her own care in the nursing home.   The $500k would go a long ways depending on what is the monthly cost at the nursing home.   And depending on what are the medical issues and the age of your Aunt.

Let's say the nursing home is $10k per month, or $120k per year.   That would be around 4 years of care.   Question, does your Aunt own a house?   If the mortgage is paid off, your Aunt could sell the house and use the equity for her care.   Did she promise the house to someone else?   Does your Aunt have Long Term insurance that would pay for nursing home care?

And there could be a chance that your Aunt might never step foot in a nursing home.   Or only be there for a couple of years.   Too bad we don't have a crystal ball.
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Before she can qualify for Medicaid she will need to spend down her assets - and these accounts are assets.
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