Why A Revocable Living Trust Can Affect A Medicaid Spend Down

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How a Revocable Living Trust Can Impact Medicaid Spend Down

Medicaid planning is critical for many individuals and families, especially those needing long-term care. Medicaid can help cover the significant costs associated with healthcare and long-term care, but to qualify, individuals must meet certain financial criteria, including the Medicaid spend down.

Understanding Medicaid Spend Down

Medicaid is a government program designed to provide healthcare coverage to individuals with limited income and resources. Applicants must meet specific income and asset limits to be eligible for Medicaid. For those who exceed these limits, a Medicaid spend down is required.

The Medicaid spend down is the process of reducing one’s countable income and assets to meet Medicaid’s eligibility requirements. Essentially, individuals need to “spend down” their excess income and assets on allowable expenses, such as medical bills or healthcare-related costs, to qualify for Medicaid coverage.

Role of Revocable Living Trusts

A Revocable Living Trust is a legal arrangement that allows individuals to place assets into a trust while retaining control over those assets during their lifetime. Typically, assets held in such trusts are not counted toward Medicaid eligibility because they are considered exempt. This exemption applies as long as the trust is revocable, meaning it can be altered or revoked by the grantor (the person who established the trust).

While Revocable Living Trusts offer advantages in terms of asset management and probate avoidance, they can complicate Medicaid eligibility due to their revocable nature. If assets in a Revocable Living Trust are counted toward Medicaid eligibility, it can affect an individual’s ability to qualify for the program or extend their spend down period.

Medicaid and Revocable Living Trusts

Medicaid has specific rules about how it treats assets held in Revocable Living Trusts. In general:

  • Countable Assets: If the assets in a Revocable Living Trust can be used for the Medicaid applicant’s support and maintenance, they are considered countable. This means they will be included in the Medicaid eligibility determination.
  • Irrevocable Trusts: Assets held in irrevocable trusts, where the grantor surrenders control and access to the assets, are typically not counted for Medicaid purposes. These assets are considered “safe” from Medicaid spend down requirements.

Planning Considerations

For individuals who have a Revocable Living Trust and anticipate the need for Medicaid benefits in the future, there are several planning considerations to keep in mind:

  • Asset Review: A thorough review of the trust and its assets is necessary. Understanding which assets are countable and exempt is crucial for Medicaid planning.
  • Timing: The timing of Medicaid application and trust funding can significantly impact eligibility. Actions taken too close to the need for Medicaid benefits may trigger penalties.
  • Professional Guidance: Consulting with an experienced elder law attorney who specializes in Medicaid planning is essential. They can help navigate the complex rules and create a strategy to protect assets while ensuring Medicaid eligibility.


While Revocable Living Trusts offer valuable benefits in terms of estate planning and asset management, they can have implications for Medicaid spend down. Understanding how these trusts are treated by Medicaid and planning accordingly is crucial for individuals seeking Medicaid benefits without jeopardizing their financial well-being.

At Morgan Legal Group, we specialize in Medicaid planning and asset protection in New York. We provide expert guidance to help you navigate the complexities of Medicaid eligibility while preserving your assets. Contact us today to ensure you can access the healthcare you need without compromising your financial security.

For more information on how a Revocable Living Trust can impact Medicaid spend down or to schedule a consultation with one of our experienced attorneys, please get in touch with Morgan Legal Group.

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 PLLP.

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