Medicaid Trusts Can Protect Your Residence From Nursing Home Care Expenses
Thomas M. Flannagan - December 9th, 2008One of the most serious financial challenges facing our clients is the staggering cost of long-term care (LTC), particularly nursing home care, with many Massachusetts nursing homes charging $333.00 or more per day for care. Very few individuals have sufficient monthly income to pay for the current and future costs of LTC, which will likely continue to increase in future years.
Many people falsely assume that Medicare will protect them from these expenses. Medicare will not pay for a long-term nursing home stay or any portion of your nursing home costs beyond your first 100 days at the facility.
LTC insurance can protect your assets from LTC expenses. Depending upon your age, health status and other factors, you may not qualify for LTC insurance or you may qualify but be unable to afford the premium for adequate coverage.
For those people for whom LTC insurance is not an option, many will rely upon the Medicaid program to pay for their LTC expenses once their assets are depleted. In order to qualify for nursing home benefits under the Medicaid program in Massachusetts, an individual cannot have more than $2,000.00 in countable assets.
“Countable assets” include virtually everything that you own including cash, CD’s, stocks, bonds, savings, annuities, retirement accounts, cash value of life insurance, vacation homes, rental real estate, and other assets.
The major noncountable asset is your home. You can qualify for Medicaid and retain your home during your lifetime. However, after your death, Medicaid will seek to recover the funds spent on your care. Because your home is the only asset left, it will be taken by the state to pay the Medicaid debt.
To protect the family home, vacation home, or other important assets from being subject to the Medicaid “spend-down” and recovery laws, many single and married senior homeowners are incorporating an Income-only Irrevocable Medicaid Trust (Medicaid Trust) into their estate plans.
With a Medicaid Trust, you retain the right only to the trust’s income during your lifetime and irrevocably waive any right to receive the principal back from the trust. However, the trust principal isn’t necessarily “locked up” during your lifetime because the Trustee may distribute principal to your children, grandchildren or other specified family members.
Only the trust’s income would be at risk to pay for your LTC expenses. The assets in the trust are fully protected under the Medicaid laws after the five-year look-back discussed below.
Other Advantages of a Properly-Prepared Medicaid Trust
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The trust assets are not subject to probate.
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You retain the ability to change the ultimate beneficiaries of the trust.
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The trust assets are not subject to the claims of your children’s creditors or your children’s divorcing spouses during your lifetime.
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By serving as Trustee of the trust, you retain overall control over the trust’s affairs until you die or become incapacitated.
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The Trustee of the trust can sell your residence and exclude the capital gain subject to the limits of Section 121 of the Internal Revenue Code[1], and purchase a replacement residence on your behalf and/or invest the sale proceeds in an income-producing asset and distribute the income to you.
A Five-Year Planning Horizon Is Essential
A Medicaid Trust can protect your assets but only after expiration of the five-year look-back period, which begins when you deed your home or transfer other assets to the trust.
The look-back period simply means that if you apply for Medicaid within five years after you transfer assets to a Medicaid Trust, you have to disclose the transfer to the government and you will be denied coverage under the program for a length of time known as the “disqualification period”.
The calculation of the disqualification period is based upon the value of your property at the time of its transfer to the Medicaid Trust and other factors. In order to avoid this trap, you should not apply for Medicaid until the five-year look back period has run its course.
As you now know, procrastination with regard to LTC planning can lead to financial devastation in which virtually all of your income and all of your assets are paid to the nursing home or taken by the state after your death, leaving your children or other loved ones with nothing.
We are knowledgeable about the planning opportunities as well as the potential pitfalls in this area of the law and would be happy to assist you with your estate planning needs.
Request a Free DVD or CD on Medicaid Trusts
During this informative program, we cover the most frequently asked questions about this type of planning including the following:
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Why is a Medicaid Trust the best way to protect a family home from a catastrophic nursing home stay?
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Who is a good candidate for this type of trust?
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How does the trust protect your right to live in your home while keeping you in a position of control over this important asset?
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Why has advance planning become absolutely crucial in this area of the law?
The information contained in this program will help you make an educated decision whether to include a Medicaid Trust in your estate plan.
To watch this program or obtain your free copy of the informational DVD or CD, please go to our Resources section and select the Estate Planning Information Center link.