🛡 Practice Area
Elder Law & Medicaid Planning
Long-term care planning, Medicaid eligibility, and asset protection
Long-term care planning, Medicaid eligibility, and asset protection
Start at least 5 years before you anticipate needing care. The earlier you plan, the more options you have.
Crisis planning is more limited but still possible. Act quickly, delays reduce your options.
Not while you're alive and living in it (or if your spouse or dependent lives there). But after death, the PA Estate Recovery Program can file a claim against your estate, including real estate. Advance planning with life estate deeds, irrevocable trusts, or caregiver child exemptions can protect the home.
You can, but if you apply for Medicaid within 5 years of the gift, you'll face a transfer penalty. At $421.20/day (2026), a $100,000 gift creates a 237-day penalty; nearly 8 months of privately paying for nursing care.
No. A revocable living trust provides zero Medicaid protection. Because you can revoke it and access the assets at any time, Medicaid counts everything in a revocable trust as an available resource. Only irrevocable trusts can protect assets, and only after the 5-year lookback has passed.
Ideally, at least 5 years before you anticipate needing long-term care. The 5-year lookback means strategies implemented today won't fully protect you until 2031. Crisis planning options exist but are more limited.
Medicare is federal health insurance for people 65+. It covers some short-term rehabilitation (up to 100 days) but does NOT pay for long-term custodial nursing home care. Medicaid is a joint federal-state program that DOES pay for long-term care, but only if you qualify financially.
Crisis planning is possible but more limited. Options include spend-down to exempt assets, spousal protection strategies, half-a-loaf gifting, Medicaid-compliant annuities, and caregiver agreements.
Under Pennsylvania's filial support law (23 Pa.C.S. § 4603), yes. It's not common, but it has been enforced; most notably in the Pittas case, where a son was ordered to pay over $90,000 for his mother's care.
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