Why Use a Medicaid Asset Protection Trust (MAPT)?
A MAPT helps reduce your countable assets so you can qualify for Medicaid when Medicare stops paying. It’s not about hiding money — it’s about planning smart so you don’t lose everything to medical costs. Medicare covers hospital and short-term rehab care, but not long-term nursing, memory care, or extended rehab stays.
In Massachusetts: the average nursing home costs between $11,000–$15,000/month, memory care $9,000–$13,000, and in-home aides $35–$45/hour. Without planning, those expenses quickly erase a lifetime of savings.
What Medicare Doesn’t Cover
It’s a common misconception that Medicare covers long-term care. It doesn’t. Medicare only covers short-term rehabilitation (up to 100 days after a hospital stay). After that, families pay out of pocket for:
- 🏥 Long-term nursing home stays
- 🧠 Memory care and Alzheimer’s care
- 🏡 Assisted living and personal care homes
- 👩⚕️ Ongoing in-home nursing or personal aide support
These services can easily cost over $150,000 per year — and after death, the state may claim reimbursement from your estate for these Medicaid-covered costs.
What Medicaid Can Recover After Death
After a person passes, the state can file a Medicaid Estate Recovery claim. They can seek repayment for the care costs by collecting from:
- 🏠 The home (if still titled in your name)
- 💰 Bank, brokerage, or retirement accounts
- 📜 Life insurance with cash value
- 🚗 Vehicles, annuities, or personal property
A properly structured MAPT prevents these assets from being exposed — ensuring your home, savings, and legacy stay in your family.
Real-World Examples
- •Agawam Couple Protects Their Home: John and Lisa placed their $450,000 home in a MAPT in 2019. When John needed nursing care in 2024, they qualified for Medicaid while keeping their home. Their children sold it later with no tax due, thanks to the step-up in cost basis rule.
Layman’s note: This means the home’s taxable value resets at death, so heirs don’t pay capital gains tax on past appreciation. - •Springfield Widow Avoids State Recovery: Maria, a retired teacher, moved her home and savings into a trust. When she entered assisted living at $10,200/month, her care was covered — and her family kept her home after she passed.
- •Ludlow Family Business Continuity: A small business owner protected his commercial property and income stream by combining a MAPT with his operating trust, ensuring both passed seamlessly to his children.
- •Chicopee Parent with Early Memory Decline: Moved assets into a MAPT during early diagnosis. Five years later, qualified for Medicaid — saving the family nearly $500,000 in care costs.
How MAPTs Work
1. Timing Matters
Assets placed into the trust before the five-year Medicaid “lookback” period are fully protected. The earlier you act, the more you keep.This is crucial as the purpose of this strategy is to reduce your countable income to qualify for free services while maintaining control of your assets for you and your heirs.
2. Stay in Control
You (or a trusted person) serve as trustee. You still live in your home, collect rent, and enjoy income — just with legal protection from future claims.
3. Fully Legal & Strategic
MAPTs follow Massachusetts Medicaid laws. It’s a proactive step families use to responsibly plan before care is needed — not after it’s too late.
Key Takeaways
Medicaid Asset Protection isn’t just for the wealthy — it’s for anyone who’s worked hard to build something and wants to keep it. Medicare only covers limited care, and one long-term illness can erase a lifetime of savings. A MAPT helps you qualify for Medicaid while protecting your home, savings, and legacy.
