Why A Revocable Living Trust Can Affect A Medicaid Spend Down

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Revocable Living Trust

How a Revocable Living Trust Can Affect Medicaid Spend Down

Medicaid serves as a vital safety net for many individuals in New York who require assistance with their healthcare costs. However, Medicaid eligibility is income and asset-based, meaning individuals must meet certain financial criteria to qualify. Many people turn to estate planning tools, such as Revocable Living Trusts, to navigate the complex process of Medicaid eligibility while preserving assets. But how does a Revocable Living Trust affect Medicaid spend down?

Understanding Medicaid Spend Down

Medicaid spending is reducing your countable assets and income to meet Medicaid’s financial eligibility criteria. These criteria may change periodically in New York, and understanding the rules is crucial. Countable assets include bank accounts, investments, real estate (excluding your primary residence), and more.

Individuals attempt to spend down their assets while preserving their heirs’ legacy by creating a Revocable Living Trust. This legal instrument allows individuals to place their assets into the trust while retaining control during their lifetime. Assets placed in the trust are not counted for Medicaid eligibility purposes as long as the trust is revocable.

The Impact of a Revocable Living Trust on Medicaid Eligibility

While a Revocable Living Trust can be a valuable estate planning tool, it’s essential to understand its implications for Medicaid eligibility, especially the Medicaid look-back period.

Medicaid employs a look-back period to examine an applicant’s financial history. In New York, this period currently spans five years. Any asset transfers or gifts made within this period are subject to scrutiny, and inappropriate transfers can result in a penalty period during which the applicant is ineligible for Medicaid benefits.

Regarding a Revocable Living Trust, assets placed within the trust during the look-back period may still be counted, potentially affecting Medicaid eligibility. If assets were transferred into the trust less than five years before applying for Medicaid, Medicaid might consider them countable resources, which can lead to a denial of benefits or a penalty period.

Strategies for Mitigating the Impact

While the revocable nature of a Revocable Living Trust may pose challenges for Medicaid eligibility, there are strategies to mitigate the impact:

  • Timely Planning: Start your Medicaid and estate planning well in advance to allow the look-back period to pass.
  • Irrevocable Trusts: Consider creating irrevocable trusts, which, unlike Revocable Living Trusts, do not count as countable assets for Medicaid eligibility purposes.
  • Professional Guidance: Consult with experienced elder law attorneys specializing in Medicaid planning to navigate the complexities of Medicaid and estate planning effectively.

It’s crucial to note that every individual’s situation is unique, and what works best for one may not be suitable for another. Consulting with professionals who understand both Medicaid and estate planning laws in New York is essential to creating a customized strategy that aligns with your goals.


A Revocable Living Trust can be a valuable estate planning tool, allowing you to maintain control of your assets while planning for Medicaid and preserving your legacy. However, it’s vital to consider the impact of a Revocable Living Trust on Medicaid spending, particularly concerning the look-back period and asset transfers. Strategic planning and professional guidance are essential to navigate these complexities effectively.

At Morgan Legal Group, we specialize in elder law, Medicaid planning, and estate planning in New York. Our experienced attorneys can help you create a comprehensive plan that aligns with your Medicaid eligibility goals while protecting your assets and legacy. Contact us today for expert guidance on Medicaid spending and estate planning in New York City.

DISCLAIMER: The information provided in this blog is for informational purposes only and should not be considered legal advice. The content of this blog may not reflect the most current legal developments. No attorney-client relationship is formed by reading this blog or contacting Morgan Legal Group.

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