Elder Law
Medicaid Planning & Long-Term Care
Planning for the cost of long-term care so a health crisis does not have to become a financial one.
Paying for Long-Term Care
Nursing home and long-term care costs can use up a lifetime of savings surprisingly quickly. Medicare generally covers only limited, short-term skilled care, and many families learn too late that ongoing custodial care is not covered at all. For many Kentuckians, Medicaid becomes the main way to pay for long-term care.
Medicaid has strict financial eligibility rules, and they are not intuitive. The program looks at what you own, how property is titled, whether you are married, and what has been given away in recent years. That last point matters: Medicaid has a look-back rule that reviews past transfers, and gifts made during that window can delay eligibility.
Medicaid planning means understanding those rules ahead of time and using the legal options available, such as Medicaid Planning Trusts and spousal protections, to help preserve a home and savings where the law allows. The earlier you plan, the more choices you typically have. Planning is also about people, not just numbers: we help families think through where a loved one wants to live, who will help manage their affairs, and how to keep a spouse at home financially secure.
What We Handle
- Medicaid Planning TrustsIrrevocable trusts designed, when established in time, to help protect assets from long-term care costs.
- Protecting the HomeUnderstanding how the home is treated and how to keep it in the family where possible.
- Spousal ProtectionsPlanning so the spouse who remains at home has the income and resources to live securely.
- Crisis PlanningGuidance when a loved one already needs nursing home care and time is short.
- Application GuidanceHelping families gather records and understand the application process.
- Coordinating Your Estate PlanUpdating wills, trusts, and powers of attorney so they support long-term care goals.
Why Planning Early Matters
Because of the look-back rule, the strongest Medicaid planning usually happens well before care is needed. Planning early can give a trust time to do its job, preserve more flexibility for a spouse, and let you make decisions calmly instead of in a hospital discharge meeting.
That said, families often come to us in the middle of a crisis, and that is okay. There may still be steps that help. The important thing is to get advice before moving money or signing anything.
Rules change. Medicaid eligibility rules are set by federal and state law and are updated from time to time. Eligibility depends on each person’s specific facts. We will review the rules that apply to you at the time you plan.
How It Works
- 1
Review Your Situation
We look at health, family, income, assets, and how property is titled to understand where you stand today.
- 2
Build a Strategy
We explain options that may help, the trade-offs of each, and how the look-back rule affects timing.
- 3
Implement & Follow Through
We prepare trusts and documents, coordinate with your family, and help you prepare for an application when the time comes.
Questions & Answers
Frequently Asked Questions
When someone applies for long-term care Medicaid, the program reviews financial transfers made during a set period before the application. Gifts or transfers for less than fair value during that window can lead to a period of ineligibility. Because the rules are detailed and can change, it is important to get advice before making gifts.
Not necessarily. Some planning options may still be available even in a crisis. The sooner you talk with an attorney, the more options may remain.
It is a type of irrevocable trust designed to hold assets so they may not be counted for Medicaid eligibility once the look-back period has passed. It requires giving up control over those assets, so it is not right for everyone.
The home receives special treatment under Medicaid rules, but there are also estate recovery rules that may apply after death. How your home is protected depends on your situation, which is why individual planning matters.
Medicare generally covers only limited skilled nursing or rehabilitation care after a qualifying hospital stay. It does not cover long-term custodial care, which is what most nursing home residents need.
Giving assets away without a plan can create serious problems, including Medicaid ineligibility, tax consequences, and exposure to your children’s creditors or divorces. Please talk with an attorney before making significant gifts.
Plan for Long-Term Care With Confidence
The best time to plan is before care is needed. The second-best time is now. Let’s talk about your family’s options.
