Medicaid Asset Protection Trusts: Technical Overview and Tax Considerations

Long-term care costs continue to increase dramatically. Taxpayers want to plan to cover these substantial costs without consuming income streams and assets they have worked lifelong to acquire. A MAPT can provide relief for eligible individuals. States have varying income and asset thresholds that individuals must fall below to qualify for Medicaid coverage. In New York, for example, applicants must have less than $31,175 in assets, while the Georgia and Colorado threshold is only $2,000. To complicate matters, Medicaid has a five-year lookback period for asset transfers.

Although MAPTs are irrevocable trusts, specific powers listed in IRC Sections 671-679 can be included in the MAPT so that the trust is taxed as a grantor trust. The grantor could be given a reversionary interest or have the power to substitute assets, for example. Since the highest tax bracket, 37 percent, begins at $15,751 for taxable income of a trust but starts at $626,351 for individuals (2025), being taxed as a grantor can be critical. Trust and estate advisers need to grasp the tax treatment of MAPTs to properly advise clients and report the income from these beneficial trusts.

Listen as our panel of elder law experts discusses how taxpayers can utilize MAPTs to minimize taxes and preserve clients' assets.

1. Medicaid Asset Protection Trusts: introduction
2. Irrevocable trusts
3. Grantor trust taxation
4. Selecting a trustee
5. Transferring assets to a MAPT
   • Lookback rules
   • Potential tax consequences
6. State-specific asset and income limits
7. Planning for income and asset limitations
8. Gift taxes
9. Qualifying for basis step-up
10. Examples

The panel will review these and other critical issues:

• Grantor trust reporting requirements
• State-specific income and asset eligibility requirements
• The look-back period for asset transfers
• Planning alternatives to qualify for Medicaid long-term care benefits

Learning Objectives

After completing this course, you will be able to:

• Identify Medicaid eligibility requirements in specific states
• Determine reporting requirements for MAPTs
• Decide how the look-back rules impact asset transfers
• Ascertain whether MAPT assets qualify for a basis step-up

• Field of Study: Taxes
• Level of Knowledge: Intermediate
• Advance Preparation: None
• Teaching Method: Seminar/Lecture
• Delivery Method: Group-Internet (via computer)
• Attendance Monitoring Method: Attendance is monitored electronically via a participant's PIN and through a series of attendance verification prompts displayed throughout the program
• Prerequisite: Three years+ business or public firm experience preparing complex tax forms and schedules, supervising other preparers or accountants. Specific knowledge and understanding of estate, gift and trust taxation including various trusts types, the unified credit, and portability.

Strafford Publications, Inc. is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of Accountancy have final authority on the acceptance of individual courses for CPE Credits. Complaints regarding registered sponsons may be submitted to NASBA through its website: www.nasbaregistry.org.

IRS Approved Provider

Strafford is an IRS-approved continuing education provider offering certified courses for Enrolled Agents (EA) and Tax Return Preparers (RTRP).