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Medicaid and the Power of Trust in New York Estate Planning

Updated: Dec 2, 2023



Navigating the intersection of Medicaid and estate planning can be a complex journey, but understanding how to protect your assets is crucial. In the realm of estate planning, one powerful tool stands out: Medicaid Asset Protection Trust, or “MAPT”. In this blog, we'll explore how placing your assets in a trust can shield them from the impact of Medicaid, offering both financial security and peace of mind.


Medicaid in New York: The Basics


Medicaid is a vital state and federally funded program that assists individuals with limited income by covering their medical expenses. While it provides essential support, it's important to recognize that Medicaid has eligibility criteria tied to income and assets. For those seeking long-term care, such as long-term nursing home care, or in-home nursing assistance, navigating these criteria becomes a key aspect of their estate planning strategy.


The Challenge: Balancing Long-Term Care Needs with Asset Preservation


As you consider your future plans, the prospect of needing long-term care may come to mind. If you possess assets, such as a home in your name, qualifying for Medicaid's free long-term nursing home care may prove challenging. Even if you do meet the eligibility criteria, the risk of a posthumous lien on your property looms large. Medicaid has the right to place a lien on your residential home after you pass away in order to recoup the costs incurred during your "free" medical care. This potential burden could significantly diminish the value of the inheritance for your loved ones. While Medicaid offers vital financial assistance for such care, its stringent asset limits, particularly in New York, prompt a crucial question: How can one protect their assets while ensuring Medicaid eligibility if the need arises?


Enter the Trust: Your Shield Against Medicaid Impacts


A trust is a legal entity that holds and manages assets on behalf of beneficiaries. It acts as a shield, allowing you to protect your assets while maintaining eligibility for Medicaid. Let's look into the key reasons why incorporating a trust into your estate plan is a smart move.


Preserving Assets for Heirs:

Placing assets in a trust allows you to designate specific beneficiaries who will inherit them. This ensures that your hard-earned assets pass smoothly to your loved ones without being depleted by long-term care expenses. A trust also avoids the probate court, that is required when there is a Last Will and Testament (or “will"), thereby accelerating the transfer of assets upon your passing.


Medicaid Asset Protection Trust (MAPT):

In New York, the Medicaid Asset Protection Trust (MAPT) is a popular tool. By transferring assets into an irrevocable trust, you relinquish ownership, making them exempt from long-term nursing home Medicaid calculations after a five-year waiting period (for in-home nursing care, the waiting period is two and a half years). This strategy can safeguard your assets while allowing you to qualify for Medicaid, if needed and planned in advance.


Retaining Control and Income:

Contrary to common misconceptions, establishing a trust doesn't mean losing control. Depending on the type of trust, you may retain the right to income generated by the assets, the right to prevent asset transfers without your consent, and the right to change the trustees and the beneficiaries. This flexibility ensures that you can continue to benefit from your assets during your lifetime without fear of losing control.


Assets in a trust avoid the court probate process, providing a seamless and efficient transfer of assets to beneficiaries. This not only saves time but also minimizes associated costs.


Planning for Disability:

A trust can also include provisions for managing your assets in the event of your incapacity, such as cognitive impairment or memory loss, offering a comprehensive approach to estate planning that considers various scenarios.


In the intricate dance between Medicaid and estate planning, a trust emerges as a reliable partner, offering protection, flexibility, and peace of mind. By proactively incorporating a trust into your estate plan, you can navigate the complexities of Medicaid while securing your legacy for future generations.


As you embark on this journey, consider consulting with experienced estate planning attorney Leslie Sultan and her estate planning team. With Leslie's expertise, you can craft a personalized trust strategy that harmonizes with your individual circumstances, ensuring both your well-being and the preservation of your valuable assets. Remember, estate planning extends beyond safeguarding wealth; it's about securing the enduring legacy you wish to leave behind. Take the first step towards comprehensive estate planning by reaching out and let your legacy be in capable hands. Contact us today for expert guidance tailored to your unique needs.



Q & A

Is Medicaid automatically given to me in New York if I need long-term healthcare either in-home or in a nursing facility?

While it provides essential support, it's important to recognize that Medicaid in New York has eligibility criteria tied to income and assets.

Even if you do meet the eligibility criteria, the risk of a posthumous lien on your property looms large. Medicaid has the right to place a lien on your residential home after you pass away in order to recoup the costs incurred during your "free" medical care. This potential burden could significantly diminish the value of the inheritance for your loved ones. For those seeking long-term care, such as long-term nursing home care, or in-home nursing assistance, navigating these criteria becomes a key aspect of their estate planning strategy.


How can I protect my assets while ensuring Medicaid eligibility if the need arises?

Placing assets in a trust allows you to designate specific beneficiaries who will inherit them. This guarantees that your hard-earned assets pass smoothly to your loved ones without being depleted by long-term care expenses. A trust also avoids the probate court, that is required when there is a Last Will and Testament (or “will"), thereby accelerating the transfer of assets upon your passing and maintaining your privacy.


What is the Medicaid Asset Protection Trust (MAPT)?

In New York, the Medicaid Asset Protection Trust (MAPT) is a popular estate planning tool. By transferring assets into an irrevocable trust, you relinquish ownership, making them exempt from long-term nursing home Medicaid calculations after a five-year waiting period (for in-home nursing care, the waiting period is two and a half years). This strategy can protect your assets while allowing you to qualify for Medicaid, if needed and planned in advance.


What if I want to stay in control of my assets and plan for incapacity or disability?

Contrary to common misconceptions, establishing a trust does not mean losing control. Depending on the type of trust, you may retain the right to income generated by the assets, the right to prevent asset transfers without your consent, and the right to change the trustees and the beneficiaries. This flexibility ensures that you can continue to benefit from your assets during your lifetime without fear of losing control.













About the Author


Leslie has been practicing law since 2009 and is the host of the estate planning podcast 'Legacy Purse'. She has a long history of representing family members struggling to inherit property and/or wealth from deceased family members through the Probate Courts. Knowing how time-consuming and expensive the probate process is, Leslie takes great pride in helping her clients learn how to plan and protect their families during their lives so they can avoid the probate court process and save their loved ones that additional grief (and expense).





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