Massachusetts residents are increasingly concerned about how to protect their homes and life savings from the rising cost of nursing home care. With the high cost of long-term care, planning ahead is not just smart—it’s essential. One of the most effective legal tools available is the Irrevocable Medicaid Asset Protection Trust (MAPT). To start the conversation today about how Silveri + Wilson can, book a call online, call us at 978-767-8540, or email us.
What is an Irrevocable Medicaid Asset Protection Trust?
This is a specialized type of Trust that can help shield your assets from being spent down to qualify for MassHealth (Massachusetts Medicaid). When used properly, it ensures that your legacy is preserved for your loved ones while still allowing you to access the long-term care benefits you may need in the future.
An Irrevocable Medicaid Asset Protection Trust is a Trust created specifically to safeguard assets from being counted by MassHealth when determining eligibility for long-term care benefits. Unlike a Revocable Living Trust, this Trust cannot be changed or dissolved by the creator of the trust (the “Grantor”) once it is established and funded.
The purpose of the Trust is straightforward: remove assets from your personal ownership so they are not considered available resources by MassHealth. Commonly transferred assets include the family home, investment accounts, bank accounts, and other valuable property.
Requirements for this Irrevocable Trust
To qualify for Medicaid protection under Massachusetts law, the Trust must meet several strict legal standards. One of the most important requirements is that the Grantor—the person creating the Trust—cannot serve as Trustee. If the Grantor retains too much control, MassHealth may consider the assets still available for care costs. The Grantor serving as the Trustee would be risky.
How You Retain Control
However, that doesn’t mean the Grantor loses all control. In fact, Massachusetts law allows the Grantor to:
- Retain the right to remove and replace the Trustee, providing ongoing oversight and a safeguard against mismanagement.
- Exercise a limited power of appointment, which allows them to change the ultimate beneficiaries of the Trust. This flexibility ensures that family dynamics or personal wishes can be adjusted over time without compromising asset protection.
The Trustee—often an adult child or trusted advisor—is responsible for managing the assets according to the terms of the Trust. The Grantor may continue to receive income generated by the Trust and can remain living in the home owned by the Trust for life.
The Massachusetts Five Year Look Back Period
MassHealth applies a five-year look-back period to any transfers made to qualify for long-term care coverage. This means that any assets transferred to the Irrevocable Medicaid Asset Protection Trust must be completed at least five years before applying for MassHealth benefits.
It is not enough to merely create the Trust. It must also be fully funded within this window. Late planning could result in disqualification or significant penalties.
What are the Benefits of this Irrevocable Trust
One of the greatest advantages of this type of Trust is that it allows you to protect valuable assets without giving up all the benefits of ownership:
- Protection from Spend-Down: Assets in the Trust are no longer countable by MassHealth.
- Continued Residence: You may continue to live in your home, which is owned by the Trust, for the rest of your life.
- Selling your Home: If you would prefer to move, the home can be sold and the proceeds can be used to buy another home.
- Income Access: The Trust can be structured to pay any generated income to you during your lifetime (interest, rents, etc).
- No Probate: Assets in the Trust pass directly to beneficiaries without going through the probate process.
- Sale Flexibility: If the Trust sells an asset—such as your home—during your lifetime, it does not reset the five-year look-back period. This is a key advantage over a Life Estate, where a sale would trigger a new five-year penalty window.
- Step-Up in Basis: Assets in the Trust generally receive a step-up in basis at your death. This means that your heirs inherit the asset at its current market value and not what you paid for it for capital gains purposes when an asset is sold.
Compared to Life Estates
While both tools are used in Medicaid planning, they differ significantly in flexibility and protection.
A Life Estate allows you to retain more control during your lifetime. However, if the property is sold while you are still living, the five-year look-back clock resets, potentially making you ineligible for MassHealth for several years.
By contrast, an Irrevocable Medicaid Asset Protection Trust provides stronger legal and financial protection. It allows for asset sales without penalty and preserves important tax advantages like the step-up in basis. While you give up some direct control, you retain meaningful oversight through the ability to change Trustees and modify beneficiaries via a limited power of appointment.
Start Planning Your Legacy Today
Planning ahead is the key to protecting your assets, preserving your legacy, and ensuring that you have access to the care you may one day need. An Irrevocable Medicaid Asset Protection Trust is a powerful strategy under Massachusetts law, but it must be carefully drafted and funded to be effective.
If you’re concerned about long-term care costs or want to make sure your assets stay in the family, now is the time to act. To start the conversation today by booking a call online, calling us at 978-767-8540, or emailing us.