Will declaration of homestead protect me against Medicaid and nursing home expenses?

A declaration of homestead in a great planning tool, but the answer to your question is YES, the state will be able to seek reimbursement, even if you have filed a declaration of homestead.  Although the state may not seek to collect on the lien until after you and your spouse die, liens imposed by the Department of Transitional Assistance for the payment of Medicaid benefits are exempt from homestead protection.  Accordingly, if your planning goal is to preserve your home for your children or other heirs, you should probably talk to an estate planning attorney  about other alternatives.

Also under Massachusetts General Laws Chapter 188, Section 1, the following types of debt are exempt from Homestead protection:

(1) sale for taxes;

(2) for a debt contracted prior to the acquisition of said estate of homestead;

(3) for a debt contracted for the purchase of said home;

(4) upon an execution issued from the probate court to enforce its judgment that a spouse pay a certain amount weekly or otherwise for the support of a spouse or minor children;

(5) where buildings on land not owned by the owner of a homestead estate are attached, levied upon or sold for the ground rent of the lot whereon they stand;

(6) upon an execution issued from a court of competent jurisdiction to enforce its judgment based upon fraud, mistake, duress, undue influence or lack of capacity.

Hope that helps.