Medicaid Asset Protection Trusts (MAPTs) vs. Revocable Trusts: Which Is Right for You?

When planning for the future, especially as we think about aging and long-term care, one of the most important questions I hear from clients is:“How do I protect my home and savings if I ever need to qualify for Medicaid?”

In Massachusetts, this usually comes down to choosing the right kind of trust. The two most common options are the Medicaid Asset Protection Trust (MAPT), also known as an Irrevocable Trust, and the Revocable Living Trust. Both serve important purposes, but they work very differently. Understanding these differences can help you make an informed decision that fits your goals.

What Is a Medicaid Asset Protection Trust (MAPT)?

A Medicaid Asset Protection Trust is an irrevocable trust designed to protect your assets from being used to pay for long-term care if you need to apply for Medicaid (called MassHealth in Massachusetts).

Here’s how it works:

• You transfer ownership of certain assets (like your home or savings) into the trust.

• Because you’ve given up ownership and control, those assets generally don’t count when the state reviews your eligibility for Medicaid.

• This means you can potentially qualify for government assistance for long-term care without depleting everything you’ve worked for.

However, this protection comes with trade-offs.

The Pros and Cons of a MAPT

✅ Benefits

1. Protects your home and savings: Assets placed in the trust are generally shielded from Medicaid liens or recovery after you pass away.

2. Helps you qualify for Medicaid: Since the assets are no longer “yours,” they typically aren’t counted toward Medicaid’s strict asset limits.

3. Preserves wealth for your family: The goal is to ensure your home and savings go to your heirs — not to long-term care costs.

4. Avoids probate: Assets in the trust pass directly to your beneficiaries without going through probate court.

   
   

⚠️ Drawbacks

1. You lose control: Because this is an irrevocable trust, you can’t be the trustee, and you can’t change your mind later.

2. You must plan early: Massachusetts has a 5-year look-back period, meaning you need to set up and fund the trust at least five years before applying for Medicaid.

3. Limited access: You can’t take money out of the trust whenever you wish, though you can still live in your home if it’s placed in the trust.

4. Complexity: These trusts must be drafted carefully to comply with MassHealth rules, so professional guidance is essential.

   
   

🏡 Example Scenario

Let’s say you own a home jointly with your children. Placing your share into a Medicaid Asset Protection Trust can help protect it from being taken to pay for long-term care. If the home is later sold, your portion of the proceeds can stay within the trust, or be used to purchase another home through the trust, so your heirs ultimately inherit it when you pass away.

What About a Revocable Living Trust?

A Revocable Living Trust is a very common estate planning tool, but it serves a different purpose.

With this type of trust:

• You stay in full control of your assets.

• You can change, add, or remove property at any time.

• The main benefit is to avoid probate and simplify the transfer of your estate after death.

However, because you maintain control, the assets in a revocable trust are still considered yours for Medicaid purposes. This means:

• Medicaid can count those assets toward your eligibility.

• They can also be subject to recovery after your death.

So, while a revocable trust offers flexibility and convenience, it does not protect assets from Medicaid or long-term care costs.

The Trade-Off: Control vs. Protection

You can’t have both full control and full protection, it’s one or the other.

• With a revocable trust, you keep control, but you risk losing assets to long-term care costs or Medicaid recovery.

• With a MAPT, you give up control, but you gain powerful protection and help ensure your assets are preserved for your loved ones.

As I often tell my clients:

“You have to lose something to gain something. The key is to understand what you’re giving up, and what you’re gaining in return.”

Important Massachusetts Rules to Know

1. 5-Year Look-Back Period: Any assets transferred into a MAPT within five years before applying for Medicaid can still be counted, delaying eligibility.

   
   

2. You Can’t Be the Trustee: You must name someone you trust (often a family member or professional) to manage the assets.

   
   

3. You Can Still Live in Your Home: Even if your home is owned by the trust, you retain the right to live there for life.

   
   

4. Timing Is Critical: The earlier you plan, the more protection your assets will have. Waiting until you need care is often too late.

A Quick Comparison

Feature	MAPT (Irrevocable Trust)	Revocable Living Trust
Control	You give up control	You stay in full control
Medicaid Eligibility	Helps you qualify	Does not help
Protection from Liens	Yes	No
Flexibility	Low	High
Probate Avoidance	Yes	Yes
Best For	Protecting assets for heirs	Simplifying estate management

The Bottom Line

If your goal is to protect your home and savings from long-term care costs while still qualifying for MassHealth in the future, a Medicaid Asset Protection Trust may be the right tool, but only if created early and structured correctly.

If your priority is flexibility and control, and you’re not as concerned about Medicaid, a revocable trust might be sufficient.

Either way, this isn’t a one-size-fits-all decision.The best trust for you depends on your age, health, family dynamics, and financial picture. Having a customized plan designed by a Massachusetts elder law or estate planning attorney can make all the difference.

Ready to explore your options? Let’s talk about which type of trust best fits your family’s needs and your long-term goals,

before it’s too late to make the choice that protects what matters most.