Creating a Medicaid Asset Protection Trust to Protect Your Future

Preparing for the inevitable takes proper planning and thoughtful consideration.  This is especially true when it comes to the protection of your assets.  This includes protection from creditors, scammers, and medical expenses, ornursing care expenses.  This article briefly explains and discusses what a Medicaid Asset Protection Trust (MAPT) is, why it is important, and how it can be used.  This type of trust is also called by other names such as a Medicaid Planning trust, Medicaid Trust, or Home Protection Trust.

*This blog is for educational purposes only and should not be considered legal advice. The use of the Paths Law Firm website does not constitute a client-lawyer relationship.

A trust is a legal entity holding title to assets.  It is a written document, like a contract, with provisions or rules on how the assets titled in the trust are to be managed and used.  Different types of trusts have different provisions and different purposes.  Usually, we assign titles to trusts describing the purpose for which they’re being used.

All trusts have three positions, one is the “grantor”.  This is usually an individual or a married couple.  The grantor creates, or starts, the trust and may also be referred to as the settlor or the trustmaker.  The second position, in no particular order, is the “trustee”.  This may be an individual, a committee of persons, or a professional trustee, usually a bank.  This position is the manager of the assets held in trust and the one responsible for following the directions regarding who is to benefit from the trust and administering it.  Finally, the third position is the “beneficiary”.  It is common for trusts to have multiple beneficiaries and this position may consist of persons, organizations, or have an overall purpose.  This is the person or entity receiving the income or the principal (assets) of the trust.

There are many different types of trusts however not all trusts are Medicaid Asset Protection Trusts. Usually, a title for a trust is assigned to describe the overall general purpose of using the trust.  This may include an irrevocable life insurance trust, a qualified spousal trust, or even the more common revocable living trust.  This title will usually tell an experienced estate planner a lot when reviewing a plan.

medicaid asset protection trust

What is a Medicaid Asset Protection Trust?

A Medicaid Asset Protection Trust, or often referred to as a MAPTfor convenience, can be a valuable planning strategy to help applicants meet Medicaid’s income and asset limits.  It is a tool used in elder law and designed to help seniors ensure their assets go to the intended beneficiary or heirs vs. being lost to the cost of care in the future.  This type of trust helps protect an applicant’s assets which would otherwise be counted in determining eligibility.  This trust is used to shield assets from nursing home care costs; however, some rules restrict the protection of the trust.  

One rule with which many people are familiar is the “5-year look-back period.”  Essentially, if any asset is transferred, whether as a gift to an individual or to MAPT, a penalty period will be assessed against the applicant.  During this penalty period, the applicant is not eligible for Medicaid benefits.  The length of the penalty period is determined by the value of the asset(s) transferred within 5 years of applying for Medicaid.

It is easiest if the assets are transferred to the trust and the trust is in place for 5 years before applying for Medicaid in order to meet the 5-year look-back period rule. However, most don’t know, but the law actually requires the penalty period to be assessed for transfers made for the purpose of qualifying for Medicaid.  An experienced attorney should help you understand how intervening factors, pre-existing conditions, and other factors impact this additional provision. 

planning for medicaid nursing care

How Does a Medicaid Protection Trust Work?

To better understand a MAPT, it is important to note the person creating the trust, referred to as a grantor, settlor, or trustmaker, should not be the trustee of the trust.  The adult children, grandchildren, or other family members can be trustee(s).  The trustee must follow the rules set by the trust, which specify how trust income and principal can be used.  Also, there are beneficiaries assigned to the trust.  The beneficiaries are the individuals who benefit from the trust.  Beneficiaries’ designations are very flexible and they may benefit from the trust during the grantor’s life or after the applicant’s death. 

For the MAPT to be compliant with Medicaid and for the assets held in the trust not to be considered when qualifying for Medicaid, the grantor cannot be a beneficiary of the trust principal, that is the assets of the trust.  If the grantor is a beneficiary, he or she would have direct access to the assets making them available to pay for care based on Medicaid’s rules. An experienced planner can discuss the options available to lessen the fears a grantor may have regarding access to their assets.

The trust must be irrevocable to be exempt fromMedicaid’s income and asset limits.  Irrevocable means the trust cannot be changed or canceled once it has been put in place.  Once income and assets have been transferred to an irrevocable trust, they are no longer considered to be controlled by or owned by the grantor.  The trust will specifically restrict transferring any assets to or back to the grantor.  This is why revocable trusts (often referred to as “living trusts”) are still in the control of the grantor and therefore counted towards the grantor’s income and asset limits set by Medicaid.

medicaid planning trust

What Are the Benefits of a Medicaid Trust?

If you are considering a Medicaid Asset Protection Trust, it is important to plan as far in advance as possible.  This is because it cannot be used immediately by an individual applying for Medicaid benefits.  Remember the 5-year look-back provision.  If an individual needs Medicaid quickly there are other laws and strategies an experienced elder law attorney can implement.  

Below are a  few of the benefits of a Medicaid Trust: 

  • Allows the applicant to place income and assets over the Medicaid limits in the trust to help meet Medicaid’s requirements without having to spend downassets.
  • The assets in the trust are protectedfor beneficiaries listed by the trustee making them protected from estate recovery.   

Shortcomings of a Medicaid Trust:

  • The trust must be set up 5 years before an individual applies for Medicaid. 
  • Income and Assets transferred into the trust are not directly or solely controlled or owned by the grantor.  The assets cannot be transferred back if the grantor becomes well enough to return home.

medicaid asset protection trusts

What Assets Can be Put in a Medicaid Planning Trust?

Assets are placed in a Medicaid Asset Protection Trust are not counted towards the asset limit if the plan is properly done.  This can help individuals applying for Medicaid to qualify, as long as the trust has been in place for a sufficient amount of time or the other factors addressed above are met. 

Essentially any type of asset can be transferred to the trust.  Some assets are highly suggested to be transferred to the trust, but a couple of types of assets are not eligible to be transferred directly.  A recommended asset eligible to be placed in a Medicaid Asset Protection Trust for planningis an individual’s home.  When a grantor transfers their home into a Medicaid Asset Protection Trust, he or she may continue to live in the home and even sell the home and purchase a new one. 

Other assets suggested to be transferred to this type of trust include other real estate, checking and savings accounts, and investments.  Good guidelines to consider when deciding which assets to transfer are 1) any assets not likely needed for a year or so, and 2) it is better to transfer more assets, rather than less.  Retirement accounts, such as a401K,IRA, and most annuities really cannot be titled in any trust because of tax implications which are best discussed with your attorney or financial advisor.

Another important factor of which to be aware of relates to income-generating assets.  If assets generate income in the Medicaid Asset Protection Trust, the grantor can collect the income generated, and the principal can continue to be protected.  Before choosing the income to be paid to the grantor, it should be considered if the income generated pushes an applicant over any benefit income limit.  Generally, when an individual is in a nursing home, any income produced by the principal in a Medicaid trust goes towards nursing home costs.  An advanced estate planning attorney can discuss the use of “spigot powers” to regulate or later control the income payments.

protecting assets from cost of care

Working with a Medicaid Planning Attorney

It is vitally important a trust is set up correctly.  There is no exception when it comes to a Medicaid Asset Protection Trust, which can be extraordinarily complex.  Because Medicaid rules change frequently it is recommended to work with anexperienced elder law attorneywho has a lot of knowledge and experience working with MAPT laws and the intricacies of trusts in general.  If a MAPT is set up incorrectly it could cause an individual to be ineligible for benefits through Medicaid, which defeats the purpose of creating this type of trust.

AtPaths Elder Law, we focus on working with seniors and their families to ensure a brighter future.  We are deeply versed in the laws of Medicaid and understand how important it is to prepare for the future with the appropriate planning strategies.  If you or a loved one needs assistance protecting your assets with a Medicaid Asset Protection Trustor other planning strategies to protect your future,contact usto schedule a consultation.   Our experienced and caring staff will work with you to create a custom plan based on your circumstances and needs. 

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We are legal experts focusing on wills, trusts, medicaid, guardianships, and asset protection for seniors and veterans in Missouri.

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Paralegal

Jennifer Scott

jennifer scott

Jennifer serves as an Estate Planning Paralegal, providing comprehensive support to the firm’s attorneys and clients. She assists in the preparation of wills, trusts, powers of attorney, and other estate planning documents, ensuring accuracy, clarity, and alignment with each client’s objectives.

Before transitioning into estate planning, Jennifer gained extensive experience as a Family Law Paralegal, this background enables her to navigate sensitive client circumstances with professionalism, discretion, and a strong understanding of family dynamics.

Jennifer is recognized for her attention to detail, strong organizational skills, and commitment to delivering a thoughtful and reassuring client experience. She approaches each matter with integrity and a focus on ensuring clients feel informed and supported throughout the process.

Outside of the office, Jennifer enjoys practicing yoga, watching sunsets, and spending time in nature—activities that provide balance and inspiration in her personal life.

Assistant to Russell Fracassa

Peyton Osborne

Peyton Osborne

Peyton serves as the Assistant to Russell Fracassa, bringing dedication, reliability, and compassion to her role at Paths Law Firm.

With prior experience supporting small businesses in administrative and operational capacities, she has developed strong organizational skills and a sharp attention to detail that help ensure both attorneys and clients are well supported.

She is currently studying at the University of Missouri–Kansas City as an Honors Student, demonstrating a strong commitment to excellence in both her academic and professional pursuits. Peyton’s work ethic and drive are reflected in the care she brings to each task and interaction.

Outside of the office, Peyton enjoys spending time with her family, reading, and exploring new places.

Probate Paralegal

Shaye Kotze

Shaye Kotze

Shaye entered the field of civil law in 2022 and has quickly developed a strong foundation in client service and legal support.

Her academic background includes an Associate of Science degree in Healthcare Services and Informatics Administration and a Bachelor of Science in Interdisciplinary Studies, with an emphasis in Health and Human Services, Social Sciences, and Humanities.

This unique blend of legal experience and healthcare-focused education allows Shaye to approach her work with both analytical precision and genuine empathy — especially when supporting families navigating complex and sensitive situations.

Outside of the office, Shaye enjoys spending time with her husband and their one-year-old daughter. Whether she’s baking sourdough, working on arts and crafts, or enjoying time outdoors, she values creating meaningful moments with her family.

Receptionist

Malia Blosser

Malia Blosser

Malia serves as the first point of contact for many of our clients, helping create a welcoming and supportive experience from the very first phone call. As our receptionist, she assists with scheduling, communication, and ensuring that each interaction reflects the care and professionalism our firm values.

She understands that many families who contact our office may be navigating stressful or uncertain situations, and she strives to make every conversation feel comfortable and reassuring.

Outside of work, Malia enjoys spending time with her husband and their two children. She loves reading, watching movies, and baking with her kids — creating meaningful memories both at home and at work.

Of Counsel

Janeece L. Dent-Bennett

Janeece L. Dent-Bennett

Janeece Dent-Bennett was born in Lexington, Missouri, in 1960 and graduated from Lexington High School in 1979.  She graduated with a Bachelor of Science in Business Administration with a major in Accounting from University of Central Missouri in Warrensburg, MO in 1982. 

In 1985, Janeece graduated with distinction from the University of Missouri-Kansas City School of Law.

Upon graduation from law school, Janeece joined the former Shughart Thomson & Kilroy, P.C. law firm (now Polsinelli) in Kansas City, Missouri, with a primary practice in corporate and business law. 

She started her own law practice in 1989 and has since practiced law in Lee’s Summit, Missouri, serving clients throughout the state of Missouri with a primary emphasis in Wills, Trusts, Estate Planning, Probate, and Business Transactions.

Janeece is married and has 3 children.  Jillian Dent is an attorney in Kansas City, Missouri.  Nathan Dent is a Certified Public Accountant in Denver, Colorado.  Andrew Bennett is an Electrical Engineer in North Kansas City, Missouri.  Her husband Mark Bennett is an IT specialist contractor for the USDA.

Recently, Janeece closed her former solo law practice of 36 years and joined Paths Law Firm in Lee’s Summit, MO as Of Counsel.

Legal Assistant

Reese M. Lehr

Reese Lehr

With a strong background in customer service and a passion for helping others, Reese brings dedication and a positive attitude to her role as a Legal Assistant at Paths Law Firm. She supports the team by managing client correspondence, organizing policies, and stepping in wherever needed to ensure clients receive the highest level of care. Known for her strong work ethic and adaptability, Reese is always ready to tackle new challenges and contribute to the firm’s mission.

Reese is currently enrolled in the Honors Program at the University of Missouri–Kansas City, where she continues to pursue academic excellence. Outside of work and school, she enjoys spending time outdoors and cherishing meaningful moments with her family and friends. Her enthusiasm, reliability, and drive make her a valuable part of the Paths Law Firm team.

Office Assistant

Christine G. Yates

Christine G. Yates
Christine serves as the Office Assistant at Paths Law Firm, where she supports day-to-day operations with a strong work ethic and a positive attitude. A student at Faith Christian Academy, Christine is passionate about pursuing a future career in both business and law, with a goal of serving her community and making a meaningful impact.
 
Outside of the office, Christine is a multi-talented individual who enjoys spending time with family and friends, playing musical instruments, practicing martial arts, cooking, exploring the outdoors, and constantly learning new skills. Her energy, curiosity, and dedication make her a valued member of the Paths team.

Legal Assistant

Bailey E. Harrison

Bailey
Bailey is a skilled Legal Assistant with a focus on elder law, providing dedicated support to both clients and attorneys. With a strong background in customer service and a certification from the University of Arkansas’ paralegal program, Bailey brings exceptional organizational skills, attention to detail, and a client-centered approach to their work.
 
Committed to efficiency and professionalism, Bailey assists in navigating complex legal matters with compassion and precision. Outside of work, Bailey maintains a balanced lifestyle by reading, staying active, and spending quality time with their cats.

Community Relations

Jeane M. Fracassa

Jeane M. Fracassa

Jeane Fracassa – a dedicated and accomplished professional who retired with an impressive 38-year service record from the Kansas City Missouri Police Department. Throughout her illustrious career, Jeane served as a Civian Supervisor in the Communications Unit, where she played a pivotal role in ensuring efficient and effective communication within the department.

Even in retirement, Jeane’s commitment to community service remains unwavering. Currently, she serves in various capacities within Community Relations at Paths Law Firm. Actively engaged in the Lee’s Summit and Overland Park communities, she proudly represents the law firm.

In all aspects of her life, Jeane Fracassa exemplifies the values of community, compassion, and family. Her commitment to making a difference and her love for exploration make her a remarkable individual, whose presence brightens the lives of those she encounters. Whether at work, with family, or during her travels, Jeane’s genuine care for others and her zest for life make her a truly remarkable and inspiring person.

Attorney

Kathleen E. Overton

Kathleen E. Overton, Attorney

Kathleen Overton is an attorney and owner at Paths Law Firm. She has more than 17 years of experience advocating for those with special needs and navigating the state and federal agencies formed to help the disabled and elderly. At Paths Law Firm, Kathleen’s practice focuses on helping the elderly qualify for nursing home Medicaid, creating estate plans to protect beneficiaries, as well as a lot of time planning and forming businesses. Kathleen also enjoys helping clients form non-profit organizations and obtain 501(c)(3) tax exempt status.

 

After attending law school at the University of Oklahoma, Kathleen began representing clients before the Social Security Administration. Eventually her practice switched to federal court appeals and Kathleen spent years representing clients before the Eastern and Western District of Missouri, the District of Kansas, and the Eighth Circuit Court of Appeals. Kathleen has since focused her practice on estate planning and elder law after watching clients struggle to find ways to financially care for loved ones with special needs or aging parents.

 

Kathleen lives in the Northland with her husband and four children. She spends her free time attending soccer matches and ballet performances with her children and starting endless home improvement projects with her husband. 

DIRECTOR OF OPERATIONS

Sydney R. Morris

Sydney R. Morris

Sydney serves as the Director of Operations at Paths Law Firm, overseeing the firm’s internal processes, team coordination, and strategic initiatives. Since joining the firm in 2017, she has grown from an experienced paralegal and internal accountant into the central force behind the firm’s operational excellence. 

She graduated with honors from the University of Missouri–Kansas City in 2022 with a Bachelor of Science in Accounting. Sydney is also a proud alumni member of Bloch Launchpad, Phi Theta Kappa, and the National Honor Society.

Outside of the office, Sydney enjoys spending time with her husband, reading, baking, and going on long walks.

FINANCIAL MANAGER

René A. Fracassa

René A. Fracassa

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

In her spare time, René is currently quite active managing multiple generations of her family, including parents and grandkids.  René has had great impact on the lives of many women teaching discipling and teaching and abundance of Bible Studies. Her former career in management and event planning trained her well to juggle all the activity.

MARKETING MANAGER

Hilary R. Tichota

Hilary Tichota

Hilary plays a vital role in managing the Marketing Department at Paths Law Firm.  She is excellent at bringing new ideas and sharing valuable resources with the law firm and our community. Hilary has been with the law firm since the beginning, working in nearly every role which is invaluable in her marketing endeavors as she brings a unique set of skills into the Marketing Department.

Hilary is nearly complete in her Bachelor’s of Arts Degree in Marketing at Park University.  She has earned the honor of being listed in National Honors Society, Phi Theta Kappa, and the Dean’s List. Hilary is always looking for new and innovative ways to share the law firm’s message.

ATTORNEY

Russell A. Fracassa (Rusty)

Attorney Russell A. Fracassa

When asked what he wants to do, his reply was “I just want to sit at the kitchen table and work directly with people.” Rusty enjoys working with clients providing experienced advocacy and supporting them through their unfamiliar and overwhelming situations. Due to all the challenges faced by seniors, it is essential to work with an experienced elder law attorney who has expertise in the law, issues, and concerns affecting seniors and their families.

Rusty brings more than 30 years legal experience and expertise working for seniors and their families as an elder law attorney in Kansas City and surrounding. Prior to law school, Rusty was an accountant and his first couple years practicing law was as a tax attorney. This provides invaluable experience in his current practice of law. Rusty’s focus is helping protect seniors’ assets from taxes and long-term care costs, benefit qualification, and navigating more complex family scenarios in their estate planning.

Rusty has personally experienced the loss every parent fears, caring for a spouse suffering with cancer and the treatment, and working with aging parents through all stages of their lives.  He intimately understands the challenges faced by individuals and their caretakers when capacity or health declines, how to prepare for it, and the legal matters while in the midst of it.  He may not be able to eliminate his client’s grief, but he strives to provide clients with peace of mind.

In 2010, Rusty’s faith and love led him and part of his family to China as Christian missionaries. He and his wife, went permanently, but ended up dedicating 3 years to that ministry. They returned to Missouri to help with grandchildren after a family tragedy and later began anew with Paths Elder Law. The goal is providing compassionate care through legal advocacy.

Rusty has multiple degrees and advanced study spanning his Bachelor’s of Arts in Business Administration – Accounting at Rockhurst College (now Rockhurst University), Masters of Arts in Accounting and in Intercultural Studies, as well as his Juris Doctorate from the University of Missouri at Kansas City School of Law.

When Rusty is not practicing law, he enjoys spending time with his family, grandchildren, and excessive eating at local restaurants.

Practice Areas

  • Wills and Trusts
  • Estate Planning
  • Asset Protection
  • Medicaid Benefits
  • VA Benefits
  • Probate
  • Guardianship and Conservatorships
  • Education

 

BSBA and Master’s in Accounting, Master’s in Inter-Cultural Studies, and Doctorate in Juris Prudence

  • Rockhurst University
  • Liberty University
  • University of Missouri – Kansas City


Admissions to Practice

  • Missouri


Professional Memberships and Affiliations

  • State Bar of Missouri
  • National Academy of Elder Law Attorneys (long-time Member)
  • Elder Counsel (Charter and Ongoing Member)
  • Missouri Association of Trial Attorneys (Past Member)
  • Kansas City Metropolitan Bar Association
  • Missouri State Bar Committees – Elder Law, Estate Planning, Probate