Legal Planning for Long-Term Care is Essential

November 6, 2025

Care demand is rising while the paid and unpaid workforce struggles to keep pace. Families often fill the gap first, then their savings and finally the public safety net. Legal planning for long-term care is essential. Without preparation, a sudden hospitalization, a memory change, or a fall can lead to rushed decisions that cost more, strain relationships and jeopardize eligibility for benefits.

What a Shortage can Change Legally and Financially

Scarce care makes timing critical. If documents are missing or outdated, facilities and agencies may not accept instructions from loved ones. If assets are titled poorly, paying for interim care can trigger taxes, penalties, or loss of need-based benefits. A plan that works in a stable market may falter when waitlists and staffing shortages appear.

Documents to Put in Place before a Crisis

Decision-Making Authority

Create or update a durable financial power of attorney and a health care proxy. Add a HIPAA release, so clinicians can speak with named agents. Confirm successors in case a first choice is unavailable.

Care Directives

Use a living will or advance directive to state preferences for interventions, placement and end-of-life care. Add a short care memo that covers routine, food preferences, mobility needs and key medications. This helps when unfamiliar staff step in.

Access To Money that Matches Care Timelines

Keep at least one liquid account titled for quick agent access. Align automatic bill pay, Social Security deposits and insurance premiums so coverage does not lapse during transitions. Review beneficiary designations to avoid conflicts with the rest of the plan.

Funding Care when Supply Is Tight

Layer Private and Public Sources

Combine income, savings and long-term care insurance with Medicaid planning, where appropriate. Map the order of withdrawals to control taxes and preserve eligibility.

Hold a Short-Term Bridge

Keep a 60 to 90-day cash buffer for deposits, respite, or agency minimums. Reimburse family caregivers through written agreements that document duties and pay, which helps with Medicaid look-back analysis.

Verify Contracts and Waitlists

Read homecare and facility agreements for rate ladders, overtime rules, cancellation terms and minimum hours. Place names on multiple waitlists and keep contact logs to prove diligence.

Guardrails against Family Conflict

Clarify Roles

Assign one person to lead medical decisions and one to lead finances or name a professional fiduciary if family dynamics are tense. Write a short communication plan that sets out how updates are shared.

Document Gifts and Caregiver Pay

Use a written caregiver agreement if a child is paid, and record hours and tasks. Note any lifetime gifts and whether they are advancements against inheritance. Clear paper trails reduce later disputes.

How an Elder Law Attorney Helps

Legal planning for long-term care is essential to avoid headaches and financial jeopardy. An attorney aligns documents, titles and funding with local rules. They structure caregiver contracts, review facility agreements and design Medicaid timelines that account for look-back periods and fair-market payments. They also develop contingency plans for placement shortages and coordinate with care managers who are familiar with local capacity. If you would like to learn more about planning for caregivers, please visit our previous posts.

Reference: Otsuka US (May 20, 2025) “New Report Shows Nearly Half of U.S. States Are on the Threshold Of A Caregiving Emergency”

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Secure Your Spouse’s access to Quality Care

August 14, 2025

When a spouse requires nursing home care, many families feel overwhelmed by the sudden medical needs, the high cost of care and the fear of losing their savings. However, with timely legal planning, you can secure your spouse’s access to quality care, while preserving your financial stability and your family’s home.

Understanding Medicaid Eligibility

Nursing home care often exceeds $90,000 per year, making Medicaid an essential resource for many couples. However, strict income and asset limits make eligibility feel out of reach for some. Medicaid’s spousal impoverishment rules help by allowing the “community spouse” (the spouse remaining at home) to retain a portion of the couple’s income and assets, while the spouse needing care qualifies for Medicaid.

Assets are divided into countable and exempt categories. Exempt assets often include the primary residence, one vehicle and personal belongings. Countable assets include checking, savings and investment accounts. Understanding how your state defines and limits these categories is crucial for effective planning and decision-making.

Why Legal Planning Is Essential for Medicaid Eligibility

Applying for Medicaid without legal guidance can result in mistakes that cause delays or penalties, especially if assets were transferred within Medicaid’s look-back period. An elder care lawyer can help you:

Spend down assets legally on exempt items, such as home repairs or a reliable vehicle.
Establish Medicaid Asset Protection Trusts to preserve assets while planning for eligibility.
Explore spousal refusal in states where this strategy can protect additional resources.

Legal planning also includes preparing powers of attorney and healthcare proxies, so your spouse or another trusted person can manage your affairs if you become incapacitated.

Preparing Emotionally and Practically for the Transition to Nursing Care

Moving a spouse into a nursing home is emotionally challenging. Visiting facilities ahead of time, discussing expectations and reviewing care options can help ease the transition. It’s equally important for caregivers to seek emotional support through counseling or community resources to manage stress.

You should also review your overall estate plan to ensure that it aligns with your family’s needs, protects your spouse’s quality of life and secures your legacy for your loved ones. Secure your spouse’s access to quality care by working with a qualified and experiences attorney. If you would like to learn more about Medicaid planning and long term care, please visit our previous posts.

Reference: Medicaid Planning Assistance (May 06, 2025) “Getting an Aging Parent, Spouse or other Loved One into Medicaid Nursing Home”

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Prepare For When Your Special Needs Child Turns 18

July 16, 2025

When a child with special needs reaches the age of majority, parents often face unexpected challenges. While the child may still depend on them for daily support, the law begins treating them as independent in many areas, including healthcare decisions, legal contracts and access to government benefits. It is important to prepare for when your special needs child turns 18.

Preparing for this transition takes more than just a birthday celebration. Parents need to address guardianship, financial planning and benefit eligibility to ensure that their child is protected and supported.

Legal Decision-Making and Guardianship

At 18, individuals are presumed legally competent to make decisions, regardless of cognitive or developmental limitations. If a child cannot safely manage finances, health care, or other responsibilities, parents must seek legal authority.

Guardianship provides comprehensive decision-making power, whereas alternatives, such as power of attorney or supported decision-making agreements, offer varying levels of autonomy. Families should consider their child’s capabilities and needs before pursuing a legal route.

Each state has different procedures and standards for granting guardianship or its alternatives. Consulting with an attorney ensures that parents choose the most appropriate legal path and comply with local requirements.

Maintaining and Maximizing Government Benefits

Reaching adulthood can also impact eligibility for programs such as Supplemental Security Income (SSI), Medicaid, or vocational rehabilitation services. Many benefits shift to individual eligibility once the child turns 18, meaning that parental income no longer factors into the qualification process.

Families should apply for SSI as early as possible after a child turns 18 to establish eligibility and start receiving monthly support. Medicaid eligibility often follows, unlocking access to medical care and home-based services.

In some cases, parents who are retired, disabled, or deceased can trigger Disabled Adult Child (DAC) benefits through Social Security for their child, which may offer higher monthly support than SSI.

Financial and Long-Term Special Needs Planning Considerations

If parents plan to leave money for a child with disabilities, it’s critical to avoid compromising government benefits. A Special Needs Trust can hold funds, while preserving eligibility for programs like Medicaid or SSI. These trusts enable funds to be used for various purposes, including therapies, education, housing and enrichment.

Families should also make sure that their own estate plans reflect their child’s needs. This might include naming a guardian or trustee, outlining care instructions and avoiding direct inheritance that could disqualify the child from assistance. Work closely with an Elder Law attorney to prepare for when your special needs child turns 18.

Key Takeaways

Turning 18 changes legal status: Parents no longer have automatic authority to make decisions unless they pursue guardianship or legal alternatives.
Benefit eligibility becomes independent: SSI and Medicaid are based on the child’s income and assets after age 18.
Legal planning is essential: Powers of attorney, supported decision-making, or full guardianship may be needed.
Special Needs Trusts protect benefits: These tools enable parents to provide financial support without jeopardizing government aid.
Estate plans must reflect future care: Naming appropriate trustees, caregivers and legal representatives ensures long-term stability.

If you would like to learn more about special needs planning, please visit our previous posts.

Reference: Special Needs Alliance (Oct. 18, 2022) “The Top 5 Things to Know When Your Child With Disabilities Turns 18”

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Including Siblings in Estate Planning for a Child with Special Needs

May 22, 2025

When parents plan for the future of a child with special needs, they often focus on legal and financial tools, like special needs trusts and government benefits. However, one crucial group is usually left out of the conversation: the siblings. Siblings may one day step into caregiving or advocacy roles, formally or informally. They may be expected to help manage a trust, ensure their brother or sister receives appropriate care, or provide emotional support. Including siblings in the estate planning process for a child with special needs creates a foundation for smoother transitions, reduces misunderstandings and gives everyone a clearer sense of their role.

Why Siblings Matter in Long-Term Planning

Siblings are likely to be the longest-standing relationships in a person’s life. As parents age or pass away, brothers or sisters often remain. Even when a sibling won’t serve as a primary caregiver or trustee, they will likely be involved in day-to-day support, communication with care providers, or an emotional anchor.

Nevertheless, siblings are often unaware of their parents’ intentions. They may not understand the purpose of a special needs trust or how decisions will be made after the parents are no longer involved. This lack of clarity can lead to confusion, resentment, or even legal conflict, particularly if siblings are also beneficiaries of the estate.

Opening the Conversation

Including siblings starts with honest communication. Parents should share the basics of their estate plan, explain how decisions have been made and invite questions or concerns. Topics may include:

Who will serve as the trustee or successor trustee of a special needs trust
How resources will be allocated among siblings
What expectations (if any) exist for caregiving or advocacy
How government benefits are being protected through legal planning

This conversation doesn’t need to happen all at once. Instead, family discussions can gradually unfold as siblings mature and understand each other’s needs. The key is ensuring that they feel informed and supported, not burdened.

Legal and Financial Education for Siblings of Special Needs Children

Parents should also ensure that siblings have access to the legal and financial information they may need someday for the family or the child with special needs. This may include providing copies of estate planning documents, explaining the function of the special needs trust, or walking them through how public benefits, like Medicaid or SSI, are affected by financial support.

Naming a sibling as a future trustee, power of attorney, or healthcare proxy without adequate preparation sets them up for stress and potential failure. Parents should consider naming a professional fiduciary or co-trustee to provide support if a sibling is unwilling or unable to serve in these roles.

Creating a Team Approach in Special Needs Planning

Planning doesn’t have to fall on one person’s shoulders. Families often succeed by creating a “care team” approach that includes parents, siblings, professionals and close family friends. Roles can be shared or divided—for example, one sibling might handle legal decisions while another provides social support.

Clear documentation of these roles within estate planning documents and written letters of intent helps ensure consistency if multiple people are involved in the care or oversight of a sibling with special needs.

Strengthening Family Bonds Through Inclusion

Including siblings in the estate planning process for a child with special needs isn’t just a practical decision—it’s an emotional one. It signals trust, values their role and lays the groundwork for cooperation. It also honors the future relationship between siblings, ensuring that love and respect continue even after the parents are gone.

Planning with siblings in mind helps prevent conflict, confusion and unintended consequences. Most importantly, it ensures that people with special needs receive the lifelong support they deserve. If you would like to learn more about special needs planning, please visit our previous posts.

Reference: MassMutual (July 19, 2023) “Living with special needs: The sibling perspective”

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Medicaid Asset Protection Trust can help with Long Term Care Costs

August 7, 2024

The numbers are clear: 70% of Americans expect to need long-term care at some point in their retirement. Many people aren’t aware of the importance of long-term care until they are uninsurable because of health conditions or can’t afford the premiums. How can you plan? A Medicaid Asset Protection Trust can help with long term care costs.

Depending upon where you live and the type of care needed, long-term care costs anywhere from $50,000 to $100,000 per year. With an average stay of two to five years, it’s a hefty financial burden without long-term care insurance, a MAPT, and good planning.

Creating a Medicaid Asset Protection Trust requires the help of an experienced estate planning attorney to be sure you obtain all of the benefits of such a trust. Long-term care costs are one of the biggest financial worries for retirees, as noted in a recent article, “This Trust Can Protect Your Assets From Long-Term Care Costs,” from Kiplinger.

The Medicaid Asset Protection Trust (MAPT) moves money out of your estate into a trust, so it becomes uncountable for Medicaid means-testing purposes. It has to be created and funded at least five years before the applicant can be deemed eligible for Medicaid funding, known as the “Medicaid look-back.”

The trust needs to be set up by an experienced estate planning attorney because there are many fine points to consider. The MAPT won’t serve its intended purpose if it’s not set up correctly.

The MAPT must be an irrevocable trust, meaning the grantor (who set up the trust) no longer has access to those assets. This can be a little unnerving. You’ll also want to speak with your estate planning attorney about your plans for the near and distant future. How will you access funds if you’re putting funds into the trust? Who will be able to access them?

This trust will also benefit families with assets closer to the old estate tax levels. In 2024, the gift and estate tax exemptions are still very high—$13.61 million. However, if the law sunsets without Congress acting, the estate tax could revert to around $5 million or lower if the federal government decides more wealth needs to be taxed. Assets in a trust are not part of the taxable estate, so having a trust also protects assets from federal and state estate taxes.

Trusts are also powerful means of controlling asset distribution. Your MAPT could distribute a set amount of money to a beneficiary throughout their lifetime, or a minor grandchild could be given a certain amount after they’ve completed four years of college or achieved a particular goal.

Consult an estate planning attorney to learn how a Medicaid Asset Protection Trust can help with long term care costs, if they’re right for you, and how to get started. If you would like to learn more about managing assets for long term care, please visit our previous posts.

Reference: Kiplinger (July 11, 2024) “This Trust Can Protect Your Assets From Long-Term Care Costs”

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Planning for Retirement with a Special Needs Child

July 8, 2024

Retirement is a time to relax and enjoy life after years of hard work. However, parents of children with special needs will need to handle this transition with care. Planning for retirement with a special needs child is critical to your child’s long-term care and your own financial future.

Beginning your retirement planning early is crucial. Likewise, this process should be an extension of your existing financial planning. Starting early allows you to anticipate state and federal benefits changes and adjust your strategies accordingly.

For instance, Medicaid waivers and other support systems can be unpredictable. Just because these benefits systems can supplement your needs today doesn’t mean they’ll be able to do so tomorrow. Flexible, far-sighted financial preparation can help you absorb changes in benefits programs.

Open communication between both parents is vital. It’s common for parents to prioritize their child’s needs over their own retirement savings. However, finding a balance is key. Both parents should be on the same page regarding their goals for retirement and their child’s future. Involving a financial planner and a special needs attorney can help align these goals and create a comprehensive plan.

Two professionals with Special Needs Alliance weighed in on planning for retirement with a special needs child. One, Jeff Yussman, emphasizes the importance of honest discussions about assets, liabilities, and the desired retirement lifestyle.

Another advisor, Emily Kile, highlights the need to leave an advocate for their child in advance. It may be smart to move a child with special needs to a future housing option while parents are still alive. This can reduce the pain and uncertainty of making such moves when the parents pass away.

The first step is reviewing the titles on your accounts, beneficiary designations and estate plans. Ensuring that the chosen trustees and agents align with the goals for your child with special needs is critical. You should consider the financial security available through life insurance policies, such as second-to-die life insurance.

Parents must also plan for the long-term care of their child with special needs. This includes preparing for the potential loss of private health insurance and understanding the longevity of their financial plans. It is important to have regular estate planning meetings that account for these factors.

While well-intentioned family members might offer to care for your child, their circumstances can change. Marriages, divorces, and other life events can impact their ability to provide consistent care. Plan for these variables to ensure your child’s stability.

Planning for retirement with a special needs child can be challenging. However, you don’t have to do it alone. If you would like to learn more about special needs planning, please visit our previous posts.

Reference: Special Needs Alliance (Oct. 7, 2022) “retirement planning steps you need to take”

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Integrating Irrevocable Trust into Medicaid Planning

June 24, 2024

When planning, especially under the umbrella of elder law and Medicaid, one tool often considered is the irrevocable trust. While reviewing the advantages and challenges of integrating an irrevocable trust into Medicaid planning, it’s important to consider the broader implications of asset management for elder care. This article helps to clarify how these trusts work, their benefits and their limitations.

An irrevocable trust serves a strategic role in Medicaid planning. By transferring assets into an irrevocable trust, these assets are generally not counted as personal assets for Medicaid eligibility purposes. This arrangement allows individuals to qualify for Medicaid, while preserving their wealth for future beneficiaries. This aspect of asset protection is paramount, as the trust shields the assets from creditors and legal claims, ensuring that the beneficiaries’ inheritance remains intact and secure.

Medicaid Asset Protection Trusts (MAPTs) are one type of irrevocable trust specifically designed to safeguard a Medicaid applicant’s assets from being counted towards Medicaid eligibility, as explained by Very Well Health. This is crucial for those whose assets would otherwise disqualify them from receiving Medicaid benefits for long-term care, which is often necessary for custodial care in nursing homes or at home.

Very Well Health notes that Irrevocable Funeral Trusts and Medicaid Compliant Annuities are also used to shield assets to enable seniors to become eligible for Medicaid benefits.

The primary advantage of using an irrevocable trust in Medicaid planning lies in its ability to protect and preserve assets. Since the assets placed in the trust are no longer under the direct control of the individual, they are effectively shielded from many forms of legal recovery efforts, including those from creditors and lawsuits. This protective measure ensures that the assets can be passed on to loved ones without being depleted by external claims or excessive taxation.

Despite their benefits, irrevocable trusts are not without their drawbacks. The most significant of these is the loss of control over the assets. Once assets are placed into an irrevocable trust, the terms of the trust cannot be easily changed, nor can the grantor retrieve the assets. This lack of flexibility can pose a problem if the financial situation of the grantor changes unexpectedly. The Medicaid five-year “look-back” period also applies, meaning that any assets transferred into the trust within five years before applying for Medicaid can incur penalties, potentially affecting Medicaid eligibility.

Setting up and maintaining an irrevocable trust involves navigating complex legal and financial planning landscapes. The trust must be structured correctly to comply with Medicaid regulations and to align with personal estate planning goals. This often requires sophisticated legal and financial advice to ensure that all aspects of the trust serve the intended purpose without unintended consequences.

Key Takeaways:

Asset Protection: Irrevocable trusts, including MAPTs, protect assets from being counted towards Medicaid eligibility, allowing individuals to qualify while preserving wealth for beneficiaries.
Benefits of Irrevocable Trusts: Assets placed in an irrevocable trust are protected from creditors and lawsuits, ensuring that the beneficiary’s inheritance remains secure.
Disadvantages of Irrevocable Trusts: Once assets are transferred into an irrevocable trust, the grantor cannot alter the trust terms or retrieve the assets, reducing flexibility. Transferring assets into a trust less than five years before applying for Medicaid can incur penalties due to the look-back period, potentially affecting eligibility.
Complex Setup Requires Legal Guidance: Establishing and maintaining an irrevocable trust requires careful legal and financial planning to ensure compliance with Medicaid rules and alignment with personal goals.

If you have the goal of integrating an irrevocable living trust into Medicaid planning, work closely with your estate planning and elder law attorneys to ensure you have covered all of the complexities of this law. If you would like to learn more about Medicaid planning, please visit our previous posts.

Reference: Very Well Health (Feb. 11, 2024) “How Medicaid Asset Protection Trusts Work”

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Considering Medicaid Asset Protection Trusts?

April 1, 2024

Medicaid, a joint state and federal program, provides health coverage to low-income individuals of all ages. Qualifying for Medicaid requires meeting strict income and asset limits, which vary by state and the type of Medicaid coverage sought. If you are considering Medicaid Asset Protection Trusts, there are a few things to know.

These limits pose a significant hurdle for many, especially those needing long-term care. According to an ElderLawAnswers article, this is where Medicaid Asset Protection Trusts (MAPTs) come into play. MAPTs offer a legal avenue to protect assets, while preserving eligibility for Medicaid benefits.

A MAPT is an irrevocable trust established during your lifetime that transfers ownership of assets to a trust, so Medicaid excludes them from the resource limit during eligibility qualification. Once transferred, you no longer own the assets directly, which helps you to meet Medicaid’s eligibility criteria. Appoint a trustee other than yourself to manage the trust and to transfer the assets, such as real estate or stocks, into the trust’s name correctly.

Key Considerations:

Timing is Crucial: A MAPT must be created and funded with Medicaid’s 60-month lookback period in mind. Assets transferred into the trust within this period may penalize your Medicaid eligibility.
Living Arrangements: Transferring your home into a MAPT doesn’t mean you have to move out. You can still reside in your home, although the trust technically owns it.
Income and Benefits: You can receive income from the trust’s assets. However, this income may affect your Medicaid eligibility.

Medicaid Asset Protection Trusts are a valuable strategy for individuals looking to qualify for Medicaid without sacrificing their assets. If you are considering Medicaid Asset Protection Trusts, work with an attorney to understand how these trusts work and the financial considerations involved, so you can make informed decisions about your long-term care planning. If you would like to learn more about elder law, please visit our previous posts.

Reference: ElderLawAnswers: What Are Medicaid Asset Protection Trusts?

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Selling the Family Home when a Loved One needs Nursing Care

November 28, 2023

When an aging relative decides the time is right to move into an assisted living or continuing care facility, families face many decisions. This is often a difficult but necessary step for older individuals with trouble living independently or planning for their future needs. Selling the family home when a loved one needs nursing care can be a challenge. A recent article from Herald—Standard, “How to handle selling a home when moving into an assisted living facility,” offers suggestions to help families navigate the process.

First, speak with an estate planning attorney to have a trusted, responsible family member be named Power of Attorney. Individuals moving into assisted living may not have any cognitive problems at the time of the move. However, selling a home for a family member who develops dementia can present complex challenges. Only a person with legal capacity may transfer their home to a new owner. Having a Power of Attorney allows a family member to step in and manage the transaction without needing to go to court and have a guardian named.

Talk about the situation and the sale with the aging family member. They will need time to process the idea of selling their home and moving. Homeowners make untold sacrifices and compromises to buy and maintain their homes, so the decision to sell a beloved home is almost always very difficult and brings out a range of emotions.

Throughout this process, an open and honest dialogue about what can be achieved by selling the home and improving their quality of life will be helpful.

Sorting through belongings is an extremely hard task. A lifetime of memories and a loss of their independence are all wrapped up in the contents of a home. It will be impossible to take the entire contents into a one or two-bedroom apartment. Take the time to sort through belongings with your family members and select certain items to give them a sense of home in a smaller space.

If possible, try to pass on some items to younger family members. Most importantly, handle this process with as much compassion as possible.

Keep all relevant people involved and current throughout the process. This is particularly important if the family members are scattered in different states. Adult children who live far away and can’t be active participants in this process shouldn’t be dismissed and left out. Open communication with other family members will minimize the chances of objections when the sale and move take place.

Finally, because this is perhaps the largest and last financial transaction, make sure the sale of their home is done with an eye to their estate plan. Selling the family home when a loved one needs nursing care may cause tax issues. There may be ways to minimize tax exposure for the individual and their estate plan. Confer with an estate planning attorney to avoid any missteps. If you would like to learn more about managing property in your estate plan, please visit our previous posts.

Reference: Herald-Standard (Oct. 27, 2023) “How to handle selling a home when moving into an assisted living facility”

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Consider using a Trust Be for Long-Term Care

November 20, 2023

More than a few seniors who are retired or nearing retirement lose sleep worrying over being able to afford the expense of long-term care, including nursing home care, which can cost thousands monthly. The fallback option for many Americans is Medicaid; according to a recent article, “Long-Term-Care planning using trusts,” from the Journal of Accountancy., Medicaid is a joint federal-state program requiring spending down assets. One option is to consider using a trust for long-term care.

To be eligible for long-term care through Medicaid, a person’s “countable” assets must fall below an extremely low ceiling—in some states, no more than $2,000, with some provisions in some states protecting the “well” spouse. States vary in terms of which assets are counted, with many exempting a primary residence, for example.

For many people, planning for Medicaid for long-term care may consider the use of an irrevocable trust. The basic idea is this: by transferring assets to an irrevocable trust at least five years before applying for Medicaid for long-term care, the Medicaid agency will not count those assets in determining whether Medicaid’s asset ceiling is satisfied.

If the planning is done wrong, there is a risk of not qualifying, thereby defeating the objective of creating the irrevocable trust. In addition, any tax planning may be undone, causing liquidity and other problems.

Some people plan to qualify for Medicaid even though they have asset levels as high as $2 million or more. Much of this may be the family’s primary residence, especially in locations like New York City, with its elevated real estate market. Costs at nursing homes are equally high, with nursing homes costing private-pay patients upwards of $20,000 a month, or $250,000 per year.

Timing is a key part of planning for Medicaid. Many estate planning attorneys recommend clients consider planning in their mid-to-late 60s or early 70s to move assets into a Medicaid Asset Preservation Trust, also called a Medicaid Asset Protection Trust.

This is because of Medicaid’s five-year lookback period. Most states have a five-year look-back period for both nursing home and home health care. If any transfer of countable assets has been made within the preceding five years of applying for long-term-care Medicaid, there will be a penalty period when the person or their family must pay for the care. The penalty is typically measured by the length of time the transferred assets could have paid for care, based on the average costs of the state or the region.

While there is no way to know when a person will need long-term care, statistically speaking, a person in their mid-to-late 60s or early 70s can expect to be healthy enough to satisfy the five-year lookback.

Why not simply make gifts to children during this time to become eligible for Medicaid? For one reason, there’s no way to prevent a child from spending money given to them for safekeeping. A trust will protect assets from a child’s creditors, and if the child should undergo a divorce, the assets won’t end up in the ex-spouse’s bank accounts.

Using a trust for Medicaid planning could be combined with gifts made to children or assets placed in trust for children, depending on the individual’s financial and familial circumstances.

The creation of a Medicaid Asset Preservation Trust is critical. The estate planning attorney must seek to accomplish two things: one, to say to Medicaid that the settlor, or creator of the trust, no longer owns the assets. At the same time, the IRS must see that the settlor still owns these assets and, therefore, receives a basis step-up at death.

If you are considering a trust for long-term care, an experienced estate planning attorney will be needed to advise you and create a Medicaid Asset Preservation Trust to meet the Medicaid and IRS requirements. If you would like to learn more about long-term care planning, please visit our previous posts.

Reference: Journal of Accountancy (Oc. 9, 2023) “Long-Term-Care planning using trusts”

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Category: Medicaid

Legal Planning for Long-Term Care is Essential

What a Shortage can Change Legally and Financially

Documents to Put in Place before a Crisis

Access To Money that Matches Care Timelines

Funding Care when Supply Is Tight

Guardrails against Family Conflict

Document Gifts and Caregiver Pay

How an Elder Law Attorney Helps

Secure Your Spouse’s access to Quality Care

Understanding Medicaid Eligibility

Why Legal Planning Is Essential for Medicaid Eligibility

Preparing Emotionally and Practically for the Transition to Nursing Care

Medicaid Asset Protection Trust can help with Long Term Care Costs

Integrating Irrevocable Trust into Medicaid Planning

Considering Medicaid Asset Protection Trusts?

Selling the Family Home when a Loved One needs Nursing Care

Consider using a Trust Be for Long-Term Care

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