A transfer into an irrevocable trust can be considered a gift for Medicaid eligibility purposes. This gift status/condition works as a significant negative for people applying for Medicaid assistance. In particular, both “penalty period” and 60 months “look-back period” rules apply.
While revocable trusts offer flexibility as they can be changed or revoked by the trustor, they won't protect assets from Medicaid. Irrevocable trusts, like Medicaid asset protection trusts (MAPTs), on the other hand, remove assets from an owner's control, rendering them eligible to meet Medicaid requirements.
Yes, a trustee can withdraw money from an irrevocable trust, but only to pay for third-party expenses and not for personal reasons. This is because it is the trustee's responsibility to manage the trust according to the to the wishes of grantor.
By setting up an irrevocable trust and transferring into it any assets in excess of the Medicaid financial limits, you can effectively shield those assets from the program's fines and other penalties. One issue here is that assets cannot be transferred back out of the trust, so you have lost control of them forever.
An irrevocable trust is created to reduce taxes and avoid probate. When you set up an irrevocable trust, you lose all ownership incidents, but this also takes the assets in the Trust off your taxable estate. The income produced by investments in an irrevocable trust is not subject to personal income tax.
The downside of irrevocable trust is that you can't change it. And you can't act as your own trustee either. Once the trust is set up and the assets are transferred, you no longer have control over them, which can be a huge danger if you aren't confident about the reason you're setting up the trust to begin with.
With the new IRS rule, assets in an irrevocable trust are not part of the owner's taxable estate at their death and are not eligible for the fair market valuation when transferred to an heir. The 2023-2 rule doesn't give an heir the higher cost basis or fair market value of the inherited asset.
And so the trustee of a trust, whether it's revocable or irrevocable, can use trust funds to pay for nursing home care for a senior. Now, that doesn't mean that the nursing home itself can access the funds that are held in an irrevocable trust. It's always the responsibility of the trustee to manage those assets.
Alone among public health care programs, a Medicaid program moves to recover health care expenses after the recipient dies. Specifcally, federal Medicaid law requires recovery against the recipient's assets if the recipient was at least 55 years old when receiving services.
There are also two state exceptions when it comes to the Look-Back Period – California and New York. There is no Look-Back Period for HCBS Waivers in California, and it's 30 months (2.5 years) for Nursing Home Medicaid, although that will be phased out by July 2026, leaving California with no Look-Back Period.
California eliminated their asset limit effective 1/1/24. While this means one's home is automatically safe from Medicaid while they are living, the home is not necessarily safe from Medicaid's Estate Recovery Program.
The moment the grantor dies, the revocable living trust automatically converts to an irrevocable trust which means no further changes can be made. While a trust can remain open for 21 years after the death of the grantor, most are closed immediately after death.
In most homeowner's policies, or “forms,” a trust listed as the named insured will be protected for damage to the insured premises, personal property and liability exposure. If the trust isn't listed, you should consider adding the trust as an additional insured.
The IRS and Irrevocable Trusts
This means that generally, the IRS cannot touch your assets in an irrevocable trust. It's always a good idea to consult with an estate planning attorney to ensure you're making the right decision when setting up your trust, though.
When the grantor of an irrevocable trust dies, the trustee or the person named successor trustee assumes control of the trust. The new trustee distributes the assets placed in the trust according to the bylaws of the trust.
Think of an irrevocable Medicaid trust as a legal agreement that holds onto client assets, typically their home and investments. The key here is irrevocable, which means that once a client transfers ownership to the trust, they can't take it back.
Irrevocable trusts are generally set up to minimize estate taxes, access government benefits, and protect assets.
Also, an irrevocable trust's terms cannot be changed, and the trust cannot be canceled without the approval of the grantor and the beneficiaries, or a court order. Because the assets within the trust are no longer the property of the trustor, a creditor cannot come after them to satisfy debts of the trustor.
With an irrevocable trust, the transfer of assets is permanent. So once the trust is created and assets are transferred, they generally can't be taken out again. You can still act as the trustee but you'd be limited to withdrawing money only on an as-needed basis to cover necessary expenses.
Protect Assets
Putting a house in an irrevocable trust protects it from creditors who might come calling after your passing – or even before. It's removed from your estate and is no longer subject to credit judgments. Similarly, you can even protect your assets from your family.
The safest path to avoiding probate is to transfer title to your trust, if your trust is a revocable living trust. If you have an irrevocable trust, that may not be the best place to own the vehicle.