Medicaid and Long-Term Care Planning

What this guide covers

• Medicaid is state-administered within a federal framework; confirm every limit, divisor, permitted device, and recovery rule against the governing state for the current year.
• The five-year lookback generates a penalty measured by value, and the penalty period does not begin until the applicant is otherwise eligible, which makes late transfers especially harmful.
• Spousal impoverishment rules protect the community spouse through a resource allowance and an income allowance; request the resource assessment early.
• Self-settled trusts are generally treated as available except within the statutory exceptions for first-party and pooled trusts and income-cap trusts.
• A third-party special needs trust must never receive the beneficiary's own assets, or it loses its exemption from the state payback.
• Whether a non-probate transfer escapes estate recovery depends entirely on whether the state has expanded its definition of 'estate.'

The full guide includes the detailed analysis, worked examples, statutory citations, and related resources below.