When you’re planning for long-term care, there’s one essential truth that can’t be overlooked: Medicaid is not the same in every state.
While Medicaid is a federal program, the way it works in practice can look very different depending on where you live—and those differences could mean the difference between protecting your life’s savings or spending them down to qualify for care.
At Axis Estate Planning, we guide Michigan families through the complex world of Medicaid planning with a deep understanding of both federal law and state-specific rules—because when it comes to protecting what matters most, one-size-fits-all simply won’t cut it.
Why the Rules Vary by State
Medicaid is funded jointly by the federal government and the states. While federal law sets the framework, each state administers its own version of the program, with flexibility in how certain rules are interpreted and applied.
That means your sibling in another state—or even your neighbor across the border—might be facing entirely different Medicaid eligibility rules than you are here in Michigan.
Examples of State-by-State Differences
Here are just a few ways that Medicaid rules can vary and why local legal guidance is essential:
- Retirement Accounts
Some states count IRAs and 401(k)s as available assets. Others don’t. - Planning Tools Like Annuities or Promissory Notes
What’s allowed in one state might be disallowed in another. - Spousal Protections
The amount a healthy spouse can retain when the other spouse needs care differs by state. - Homestead Exemptions
Whether or not your home remains protected when transferred into a trust can depend on how your state defines “exempt” property.
Medicaid Asset Protection Trusts (MAPTs): Powerful, But Not Universal
Medicaid Asset Protection Trusts (MAPTs) are an effective strategy to safeguard your home and savings from long-term care costs—but they must be tailored to your state’s rules to be effective.
For example:
- Trustee Rules: Some states restrict who can serve as trustee, especially if the person setting up the trust maintains control.
- Income Rights: Some states allow income to be retained without penalty; others may count it against eligibility.
- Use of the Home: In some states, you can retain the right to live in your home even if it’s placed in a trust. In others, that could disqualify you from benefits.
A trust that works beautifully in Florida may completely fail here in Michigan.
Why Local Legal Guidance Matters
With ongoing uncertainty about the future of Medicaid at the federal level—including potential cuts and shifts in funding—relying on a generic plan is risky.
The cost of long-term care is rising, and more families will need to rely on Medicaid to help cover those expenses. Planning now, with the right strategies for Michigan, is one of the most important financial decisions you can make.
Let’s Make Sure Your Plan Is Ready—When It Matters Most.
If you’re considering a Medicaid Asset Protection Trust or any long-term care planning strategy, don’t go it alone. Work with a trusted estate planning attorney who understands the nuances of Michigan law and how to protect your assets the right way.
Visit Us: 900 Wilshire Drive, Suite 105, Troy, MI 48084
Call Us: (248) 251-1001
Learn More: www.axisattorneys.com
Axis Estate Planning
Trusted. Thoughtful. Here for what matters most.
Axis Estate Planning | Trusted. Thoughtful. Here for what matters most.
At Axis Estate Planning, we’ve worked with countless families caught off guard by a sudden health crisis—often when a loved one needs immediate nursing home or in-home care. In these moments, decisions become urgent, options are limited, and missteps can be costly.
One of the most misunderstood and impactful rules in Medicaid eligibility is the five-year look-back period. It can determine whether your family receives the support they need—or is forced to spend down hard-earned assets.
What Is the Medicaid Look-Back Rule?
When you apply for long-term care Medicaid—the program that helps pay for skilled nursing or at-home support—the government reviews your financial history for the five years leading up to the application. This is known as the “look-back period.”
During this time frame, Medicaid checks for:
- Asset transfers
- Property sales below market value
- Large financial gifts
- Other transactions that appear to reduce your wealth intentionally
If any red flags are raised, Medicaid can impose a penalty period—a span of months or even years when you are ineligible for benefits. That delay can result in tens of thousands of dollars in out-of-pocket costs, right when you need care the most.
Common Mistakes That Can Trigger Penalties
Michigan families often face challenges not because of bad intentions—but because of a lack of awareness about how Medicaid rules work. Some of the most common missteps we see include:
- Gifting money to children or grandchildren—even for special occasions
- Adding a loved one to a home title without full payment
- Selling property to family at a discounted rate
- Donating to charities close to the time of application
- Co-signing on a loan or helping with a down payment without proper documentation
While these actions may feel generous or routine, they can be seen as uncompensated transfers under Medicaid rules—and result in a penalty.
Why Proactive Planning Matters
At Axis Estate Planning, we believe the best time to plan is before a crisis strikes. By taking action early, families can access more legal strategies to protect assets, reduce penalties, and ensure care is covered when it’s needed most.
We help our clients implement proven tools such as:
- Medicaid Asset Protection Trusts (MAPTs)
- Caregiver Agreements that document in-home support
- Customized Spend-Down Plans that align with Medicaid guidelines
Even if you’re already inside the five-year window, we may still be able to help mitigate penalties and preserve resources. The earlier you begin, the more options you’ll have.
The Axis Estate Planning Approach
The Medicaid look-back rule can feel overwhelming—but with the right guidance, it doesn’t have to be. Our team offers families across Michigan clear, compassionate, and legally sound solutions to navigate the complexity of long-term care planning.
We’re here to help you take control of your future—with dignity, foresight, and protection for what matters most.
Visit Us: 900 Wilshire Drive, Suite 105, Troy, MI 48084
Call Us: (248) 251-1001
Learn More: www.axisattorneys.com
Axis Estate Planning
Trusted. Thoughtful. Here for what matters most.
At Axis Estate Planning, we believe that true estate planning isn’t just about preparing for what happens after you’re gone—it’s about protecting your future while you’re living, thriving, and caring for those you love.
Today, one of the most important aspects of modern estate planning is planning for long-term care—and understanding how Medicaid fits into that plan.
With healthcare costs climbing and long-term care making headlines, it’s more critical than ever to have a strategy in place that secures your care without sacrificing your financial legacy.
The True Cost of Long-Term Care
The reality is stark: whether through a nursing home or in-home services, the cost of long-term care can deplete a lifetime of savings in just a few short years.
- The average annual cost of nursing home care now exceeds six figures.
- Medicare offers limited healthcare benefits—and crucially, it does not cover extended nursing home stays.
- Medicaid is often the only financial safety net available for long-term care.
But qualifying for Medicaid isn’t as simple as it seems. Strict income and asset limits mean that without the right planning, families may be forced to spend down their life savings just to become eligible.
At Axis, we believe you deserve better.
How Estate Planning and Medicaid Work Together
Without thoughtful estate planning, the dream of passing on a legacy—or even maintaining financial dignity in later years—can slip away. That’s why integrating Medicaid planning into your estate plan is a powerful, proactive move.
Here’s how we help you protect what matters most:
- Irrevocable Trusts: These trusts can safeguard your assets from being counted against Medicaid eligibility while still providing security for your loved ones.
- Asset Protection Planning: Carefully structuring how your assets are held can help preserve your wealth for future generations.
- Strategic Gifting: With the right timing and strategy, gifting can reduce your countable assets and help you meet Medicaid eligibility guidelines without risking penalties.
- Spousal Planning: If you’re married, we help you navigate Medicaid rules that can protect the healthy spouse from financial devastation while securing care for the other.
- Planning ahead—ideally years before care is needed—gives you the best opportunity to shield your family’s future. Waiting for a health crisis can severely limit your options.
Why Early Planning Matters
The best time to plan for long-term care is when you’re healthy, vibrant, and able to make clear, confident decisions about your future.
A well-structured estate plan integrated with Medicaid strategies:
- Ensures access to quality care when you need it most
- Protects your home, savings, and retirement accounts
- Preserves your ability to leave a meaningful legacy to those you love
Estate planning isn’t just about who gets what—it’s about ensuring peace of mind, stability, and security for every chapter of life.
At Axis Estate Planning, we’re here to walk this journey with you—listening, guiding, and crafting a plan that honors your life’s work and protects your family’s future.
Let’s Talk About Your Future
As healthcare costs and public benefits continue to evolve, partnering with an experienced estate planning attorney who understands Medicaid is more important than ever.
At Axis, we bring trusted guidance, thoughtful strategy, and a deep commitment to protecting what matters most—your family, your legacy, your life.
Visit Us: 900 Wilshire Drive, Suite 105, Troy, MI 48084
Call Us: (248) 251-1001
Learn More: www.axisattorneys.com
Axis Estate Planning
Trusted. Thoughtful. Here for what matters most.
