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4 Key Things to Know about Trusts and Medicaid Planning


When it comes time to pay NH for care, we should just be grateful we live in a country that has a system in place for the elderly.

My mom and I began the process of getting an irrevocable trust for her condo, but then I was told by an elder care social worker who does a lot of Medicaid eligibility work that if it is her primary residence, which it is, it might not be as important to put that into a trust as to look at her income and liquid assets and find a way to protect that from Medicaid using it as a way to decline her. Is that true? I would prefer not to put the condo into a trust because the conditions can never change and I will inherit the property and don't want to be limited. I would love to hear some opinions about whether it is really worth the effort and expense to have a lawyer do the trust, or is it better to get an elder care lawyer to work on her income and other asset issues.

I would like to say the above info wish it applied to me me, but it didn't. Thanx for your detailed response though.
Mom has no spouse. She has no property. She can't live with me, any longer as her Alzheimer's is too far gone for me to handle anymore. She is paying to live at a wonderful center now, but is she can't walk any longer...she has to leave. The nursing homes where I live are very few and not too great. When she runs out of money, I must apply for Medicaid. That is the reason for the question.

If you need to get someone on Medicaid, you may not need a trust if they have low assets already. A community spouse is allowed a home, some savings and limited income in many states. If people claim they plan to return to their home, the home is usually safe until after their death. If not in their name at that time, there is usually no state recourse (speak w/ an elder lawyer in this case!) Definitely ask what the state-allowed amount is.
The downside to Medicaid planning can be if it means someone you love is now going to have to go to a nursing home, share a room with 3 strangers and have no other options. To get in to a good nursing home, it is better to show up with a few months of funds, or if there has been a 3 midnight Medicare paid hospitalization, get discharged to the best Medicare/Medicaid approved nursing home in your preferred area. Once there, you cannot be evicted for using Medicaid.
Most people in nursing homes do not need 24/7 skilled care. See if there is a way to pay for care at home where they may prefer, or in a quality residential care facility with 4-10 residents. When a facility is private pay, there is a greater incentive and an ability to provide quality care. Saving, investing and insuring for long-term care can help avoid the need to stay in a nursing home. These days, virtually any life insurance can be cashed in, and annuities can be designed for lifetime income if there are still some assets available. I worked in Medicaid nursing homes for several years. Being able to remain home with paid help, or get quality care in a private pay scenario is most folks preference when skilled 24/7 care is not necessary.

Do you know Id Medicaid looks at tax returns? Also do they look to see if your have an IRA....?

the irrevocable trust does not work any more in Michigan. We were denied Medicare just for that reason. The state has decided to "redefine" it's law, so were had to undo it all and start over again. Check with your state laws first before starting this long and costly procedure.


This is real helpful, I have a disable son who is 30.I am care proder for him with mosaic

Have a handicapped son I who is 30.And I want to set up a trust for him.