Facing the prospect of long-term care and the complexities of Medicaid eligibility? A Medicaid Asset Protection Trust could be your safeguard. This legal strategy allows you to secure your assets while fulfilling Medicaid’s financial requirements. This article cuts through the complexity to show you exactly what a MAPT is, how it operates, and the benefits it offers—while also alerting you to important considerations like the look-back period and control over your assets. Get ready for a clear path through the maze of Medicaid planning.

Key Takeaways

  • Medicaid Asset Protection Trusts (MAPTs) are designed to help individuals meet Medicaid eligibility requirements while shielding their assets from being counted or having to be used to pay for care until they qualify.
  • Understanding the distinctions between countable and non-countable assets is crucial for Medicaid eligibility, and there’s a five-year look-back period where undervalued asset transfers can lead to penalties and delayed eligibility.
  • While MAPTs can provide estate recovery avoidance and tax benefits, they also involve loss of control over assets and potential penalties due to the look-back period, with establishment and maintenance costs ranging from $4,000 to $12,000. However when comparing the cost to the potential assets at risk, the cost can easily be made up if it saves more than 1-2 months of long term care costs (Currently approximately $8,500.00 per month in Michigan).

The Basics of Medicaid Asset Protection Trusts

Medicaid Asset Protection Trusts (MAPTs) are legal tools designed to:

  • Shield an individual’s assets from being considered in Medicaid eligibility assessments
  • Move assets into an MAPT to help preserve them for future generations instead of to pay for care
  • Reduce countable assets
  • Meet Medicaid’s financial eligibility requirements.

MAPTs can also provide tax benefits. With advantages related to regular income and capital gains tax, MAPTs support individuals in meeting Medicaid eligibility requirements while also protecting their assets in a tax-efficient manner. This is particularly useful for people with significant assets who might otherwise surpass Medicaid’s asset limit.

What is an MAPT?

A Medicaid Asset Protection Trust, also known as a Medicaid Planning Trust or Home Protection Trust, is an irrevocable trust. Its main objective is to protect assets of a Medicaid applicant from being considered for eligibility assessment, thereby enabling them to meet the criteria for Medicaid benefits without exhausting their resources.

One should bear in mind that control and access to assets in such a trust are constrained in some ways, which guarantees they are not included in Medicaid’s asset limit. However a carefully drafted trust can ensure that the right balance of protection and flexibility is created.

How MAPTs Work

In an MAPT, the trustmaker may retain all or some of the income generated by the assets, while the principal is safeguarded. However, this income must not surpass Medicaid’s income limit, as this could affect eligibility. It’s worth noting that retirement accounts such as 401k’s and IRAs may not be placed in a trust, and some special planning and considerations should be taken in regards to protecting these types of assets.

The government also carefully evaluates any underpriced transfer assets, particularly those below fair market value, during a specific timeframe known as the Medicaid look-back period. Any asset transfers made during this period could postpone eligibility for nursing home care. Working with a trained attorney can help make sure that all transfers are done correctly to avoid potential complications.

Eligibility Requirements for Medicaid and Trusts

Understanding the distinction between countable and exempt assets is a significant factor when assessing eligibility for Medicaid. Countable assets include bank accounts, stocks, bonds, and property that is not a primary residence. Meanwhile, exempt assets typically encompass the primary residence, personal property, and prepaid funeral expenses, and other qualified assets. In certain cases, individuals may need to utilize a portion of their assets to offset long-term care or other medical expenses, a process known as the spend-down requirement. However, while your home may be exempt, it can be subject to estate recovery after your passing.

One should also keep in mind the Medicaid look-back period. This period of five years (or 30 months in California) scrutinizes any undervalued asset transfers. If assets are transferred during this period, penalties may be incurred, potentially delaying eligibility for nursing home care under Medicaid.

Income Limitations

Medicaid imposes income thresholds for eligibility, which vary depending on the state and program. As of 2023, the individual income limit for Nursing Home Medicaid and Medicaid Waivers is $2,742 per month ($32,911 per year) in most states. Certain categories of income are not subject to Medicaid’s income limits, including the $20 General Income Deduction and the $65 Earned Income Deduction plus half of the remaining earned income. With these deductions taken into account, the income limit permitted for nursing home care eligibility remains unchanged.

Income from sources such as 401K or IRA payouts, or a rental property, can also impact Medicaid eligibility.

Countable vs. Non-Countable Assets

Countable assets usually consist of bank accounts, certificates of deposit, life insurance policies with a face value exceeding the state’s exemption limit, stocks, bonds, and property that is not classified as the primary home. These assets are considered when determining eligibility for certain benefits or financial assistance. Non-countable assets typically comprise the applicant’s primary residence and most personal belongings, as well as home improvements and pre-paid funeral and burial expenses. These are considered exempt from certain calculations. Understanding these classifications is key in optimizing the use of an MAPT for Medicaid eligibility.

Types of Trusts: Revocable vs. Irrevocable

In terms of Medicaid asset protection, understanding the difference between revocable and irrevocable trusts is key. While a revocable trust grants control and access to the assets to the grantor, an irrevocable trust limits access to some assets. This distinction has significant implications for Medicaid planning.

Assets held in a revocable trust are not shielded from Medicaid. On the other hand, an irrevocable trust provides Medicaid asset protection by transferring the assets into a special trust, rendering them unavailable for Medicaid eligibility and asset calculation. It is not correct to say all control over assets in a MAPT is lost- there are ways to write in controls, while still protecting assets.

Revocable Trusts

A revocable trust is a form of trust that allows for the terms to be modified after establishment, typically within the grantor’s lifetime. This flexibility enables the grantor to retain authority over the trust assets. However, for Medicaid eligibility, assets held in a revocable trust are considered countable, as the grantor can use the funds for his or her benefit.

This means that these Medicaid trusts do not offer sufficient protection for Medicaid planning purposes.

Irrevocable Trusts

On the other hand, an irrevocable trust is a trust that gives away an asset irrevocably, however again, all is not lost- you may still use your residence, control investments, take income if appropriate. You are simply designating that these assets are ultimately for someone else in order to protect them. This type of trust is utilized in Medicaid planning to safeguard assets from being considered for eligibility assessment.

Setting Up a Medicaid Asset Protection Trust

Setting up an MAPT necessitates meticulous planning and is best undertaken with the help of a Medicaid lawyer who is well-versed with the MAPT regulations in your state. One should also be conscious of potential hurdles that may emerge during the process, such as losing control over assets and the requirement for advanced planning due to the irrevocable nature of the trust.

Working closely with an attorney to ensure adherence to these and other legal requirements is essential.

Pros and Cons of Establishing an MAPT

Setting up an MAPT has both benefits and drawbacks. On the upside, an MAPT enables an individual to comply with Medicaid’s asset limit without the necessity to deplete their own assets. It also provides tax benefits related to regular income and capital gains, aiding individuals in Medicaid eligibility while also safeguarding their assets in a tax-efficient way.

However, there are also downsides to consider. Establishing an MAPT results in the individual being unable to access certain assets, thereby leading to restricted access to and control over the assets held in the trust. Furthermore, the five-year look-back period can lead to penalties, potentially delaying eligibility for nursing home care under Medicaid.


MAPTs offer several key advantages:

  • They enable individuals to qualify for long-term care benefits from Medicaid
  • They safeguard assets from depletion in the event of long-term care needs
  • This protects the assets for beneficiaries and shields them from Medicaid’s estate recovery attempts.

MAPTs also offer tax benefits related to regular income and capital gains taxes, aiding individuals in meeting Medicaid eligibility requirements and sheltering their assets in a tax-efficient way.

Alternative Strategies for Medicaid Planning

Although MAPTs are a commonly used instrument for Medicaid planning, they are not the sole option. Other strategies can be utilized for long-term care planning, such as long-term care insurance.

Long-term care insurance offers an alternative means of financing long-term care services and could potentially supplement or substitute the necessity for Medicaid coverage. The issue is that finding cost effective long term care insurance can be difficult ot find.

Long-Term Care Insurance

Long-term care insurance comes in both traditional and hybrid forms, providing flexibility in choosing a strategy to protect against potential long-term care costs. Traditional long-term care insurance requires an annual premium payment for the duration of the policyholder’s life, while hybrid insurance integrates the advantages of a conventional life insurance policy with long-term care coverage.

Gifting and Annuities

Gifting assets can provide more flexibility compared to other strategies, but it contradicts Medicaid’s Look Back Rule, which could result in a period of Medicaid ineligibility as a penalty.

Annuities, on the other hand, provide the capability to safeguard your principal from market losses, making them advantageous for asset protection. Furthermore, annuities are recognized as retirement savings instruments, further enhancing their utility in asset protection strategies. However the income can cause issues and should be utilized as a careful planning tool with the assistance of an attorney.


To conclude, Medicaid Asset Protection Trusts offer a viable strategy for individuals seeking to protect their assets while qualifying for Medicaid benefits. However, establishing an MAPT requires careful planning, understanding of the Medicaid eligibility criteria, and strict adherence to certain legal requirements. The use of alternative strategies, such as long-term care insurance and gifting assets, can also form part of an effective Medicaid planning approach. Therefore, it is essential to seek expert advice and carefully consider all available options to ensure the best possible outcome for you and your loved ones.

Frequently Asked Questions

What are the disadvantages of a Medicaid asset protection trust?

Medicaid asset protection trusts have drawbacks that may make clients feel uneasy. These drawbacks can include limited access to assets placed in the trust and the potential for complicated administration. However careful planning can lessen these fears and retain control over assets in a balanced manner.

Does putting your home in a trust protect it from Medicaid in Michigan?

Yes, putting your home in an irrevocable asset protection trust can help protect it from Medicaid in Michigan. It may be beneficial to consider placing your property in an irrevocable trust for asset protection.

What is the difference between a trust and an asset protection trust?

The key difference between a trust and an asset protection trust lies in their purpose. While a regular trust is used to pass on assets to beneficiaries, an asset protection trust is specifically designed to shield assets from creditors, while also planning to pass those assets to beneficiaries.

What is the five year rule for trusts?

The five-year rule for the lookback period in regards to Medicaid Asset Protection Trust, allows assets placed in the trust to become exempt from Medicaid spend down requirements after a 5-year look-back period.

What is a Medicaid Asset Protection Trust (MAPT)?

A Medicaid Asset Protection Trust (MAPT) is an irrevocable trust that helps protect a family’s assets and improves an individual’s eligibility for Medicaid.