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Designing Trusts to Address Long-Term Care Costs

Posted On: April 25, 2025

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Todd M. Villarrubia, an authority in wealth planning and preservation, brings over 30 years of in-depth, experience to the complex challenges of safeguarding familial and individual wealth. Based in New Orleans, Louisiana, his expertise is not only recognized in the local community but also reverberates within the legal industry.
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Worried about long-term care draining your life savings? Discover how long-term care trusts can help protect your assets, ensure Medicaid eligibility, and preserve your legacy through smart elder law planning.

Planning for the future isn’t just about passing on wealth—it’s also about preparing for the rising costs of aging. One of the biggest financial risks retirees face? Long-term care costs. Whether it’s in-home assistance, assisted living, or a nursing facility, care expenses can drain savings fast if there’s no plan in place.

That’s where smart elder law planning comes in. By designing the right kind of trust, you can protect your assets, stay eligible for benefits like Medicaid, and give your loved ones peace of mind.

The High Cost of Long-Term Care

Today, the average cost of a private nursing home room in the U.S. exceeds $100,000 per year—and it's only going up. Most health insurance policies and Medicare don’t cover extended care. That leaves families scrambling to pay out of pocket, often spending down retirement accounts or even selling property.

But there’s a better way. With long-term care trusts, you can preserve your wealth while still preparing for care when you need it.

What Is a Long-Term Care Trust?

A long-term care trust is typically a type of irrevocable trust that protects assets from being counted when applying for Medicaid. It allows you to transfer ownership of certain assets—like your home, savings, or investments—out of your name while still allowing you to benefit from them indirectly.

Because Medicaid has strict asset and income limits, this strategy helps you qualify without losing everything you’ve worked for. But timing is critical—especially when it comes to the Medicaid look-back period.

How Trusts Fit Into Elder Law Planning

Here’s how the right long-term care trust can support your elder law planning goals:

  1. Protects Assets from Spend-Down
    Once assets are placed in an irrevocable trust, they’re no longer counted toward Medicaid eligibility—after the 5-year look-back period.
  2. Ensures Eligibility for Medicaid
    Trusts help meet asset thresholds without having to "spend down" your estate.
  3. Preserves a Legacy for Heirs
    Instead of watching your estate vanish to care costs, you can keep assets intact for the next generation.
  4. Customizable for Your Goals
    Trusts can include clauses for healthcare wishes, income distribution, or housing arrangements.
  5. Reduces Conflict and Uncertainty
    With clear legal structures in place, your family won’t be left guessing—or fighting—about how to handle care and finances.

What to Consider When Creating a Long-Term Care Trust

  • Timing is everything. Transfers to a trust must happen at least five years before applying for Medicaid to avoid penalties.
  • The trust must be irrevocable. You can’t retain control or access to the principal directly.
  • Choose a reliable trustee. This person will manage the trust for your benefit and should understand your wishes.
  • Coordinate with other estate documents. Trusts should align with your overall estate planning for aging parents or for yourself.

Final Thoughts: A Smarter Way to Plan for Care

Long-term care is one of the biggest unknowns in retirement planning—but it doesn’t have to catch your family off guard. With the right trust structure, you can plan ahead, protect your assets, and ensure you get the care you deserve without burdening your loved ones.

Let’s Create a Plan That Cares for You and Your Legacy

At Wealth Planning Law Group, we help families design long-term care trusts that align with their personal values, financial goals, and Medicaid strategy. If you’re concerned about rising long-term care costs or want to help aging parents protect what they’ve built, we’re here to guide you.

Schedule a consultation today to start your custom elder law planning strategy and gain peace of mind for the road ahead.

Photo by Ekaterina Shakharova on Unsplash

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