One of the biggest concerns people have as they get older is what happens to their home and savings if they eventually need nursing home care.
After spending a lifetime working, paying off a mortgage, and building something for their family, most people don't want to lose everything to nursing home expenses.
That's why one question comes up frequently:
"Can I put my house into a Medicaid Trust, have MassHealth pay for my nursing home, and still leave the house to my children?"
The short answer is yes, that may be possible. But there are important rules, and simply putting your house into a trust does not automatically qualify you for MassHealth.
First, who pays for nursing home care?
Medicare and Medicaid are different programs.
Medicare generally does not pay for long-term nursing home care when someone needs ongoing help with everyday activities.
Medicaid, known as MassHealth in Massachusetts, may cover long-term nursing home care if you meet certain medical and financial requirements. When you apply, MassHealth reviews your income, assets, and financial history.
If you have too many countable assets, you may need to spend some of your money on care or other permitted expenses before qualifying. This is called a spend-down.
Even after qualifying, you generally must contribute much of your monthly income, such as Social Security or pension payments, toward your care. MassHealth then pays the covered balance.
How does a Medicaid Trust help?
Let's say you own a house worth $500,000 and want your children to inherit it. You may be able to transfer the house into a properly drafted Medicaid Asset Protection Trust. This is generally an irrevocable trust, meaning you give up certain rights and control over the property.
But timing is extremely important.
MassHealth generally reviews asset transfers made within five years before an application for long-term nursing home coverage.
For example, suppose you transfer your home into a Medicaid Trust in 2026.
If you need nursing home care in 2028, that transfer could result in a period when MassHealth will not pay for your nursing home services. But what if you apply in 2032, more than five years later? If the trust is properly structured and meets MassHealth requirements, the house may no longer count as an available asset.
You would still need to qualify medically and financially, but MassHealth could potentially pay for your nursing home care while the house remains in the trust for your beneficiaries.
Why not just give the house to your children?
You might wonder why you need a trust at all. Giving your home directly to your children may also be an option, particularly when the transfer occurs well before you need MassHealth.
But once you give them the house, it legally belongs to them. If they face financial problems, divorce, or lawsuits, the property could be at risk. A properly structured Medicaid Trust may offer more control over how the property is managed and eventually passed to your children, while allowing you to retain certain limited rights.
Does this mean MassHealth will automatically pay?
No. And this is where families need to be careful.
A Medicaid Trust is not a way to hide assets from the government. Transfers must be disclosed when required, and even an irrevocable trust may fail to protect your home if its terms allow you access to assets that MassHealth considers available.
Also, passing the five-year mark does not guarantee approval.
Your income, remaining assets, medical needs, and the trust's actual terms still matter.
So, can you protect your home and qualify for MassHealth?
Potentially, yes. That's one of the main reasons families consider Medicaid Asset Protection Trusts. But planning should begin well before nursing home care becomes necessary. And because these trusts are generally irrevocable, decisions about transferring your property should never be taken lightly.
At the Law Office of Louis S. Haskell, we help Massachusetts families review their estate planning options and understand whether a Medicaid Trust makes sense for their situation.
Before transferring your home or savings, speak with an attorney who understands Massachusetts estate planning and MassHealth rules.
Because the goal isn't just to put your house into a trust. It's to make sure your plan works when your family needs it most.
TL;DR
A properly structured Medicaid Trust may help protect your home while allowing you to qualify for MassHealth nursing home coverage.
MassHealth generally applies a five-year look-back rule to asset transfers.
Transferring your house into a trust does not automatically qualify you for MassHealth.
Medicaid Trusts are generally irrevocable, so careful planning with an attorney is important.
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A Medicaid Trust may help Massachusetts families protect their homes from future nursing home costs. Learn how the five-year look-back rule works, what MassHealth considers when reviewing eligibility, and why early estate planning matters.