A Medicaid Asset Protection Trust (MAPT) is an irrevocable trust that holds your home and savings so that, once the assets have been in the trust longer than Virginia’s five-year look-back, they no longer count against you when you apply for Medicaid to pay for long-term care. Drafted correctly, a MAPT can also keep those assets out of Virginia’s Medicaid estate recovery after you pass away, while still letting you decide who inherits. The weight of this whole strategy rests on that word “correctly,” and in Virginia it carries more weight than in most states, because a retained right to income or to live in the home can pull the assets back within reach of estate recovery. Here is why, and how the trust actually works.
Key takeaways
- A MAPT is irrevocable. A revocable living trust protects nothing from Medicaid.
- The assets must be in the trust for more than five years (60 months) before you apply for Medicaid.
- In Virginia, a retained right to live in the home or to receive income can expose the home to estate recovery, so the trust has to be drafted with that risk in mind.
- A MAPT can be written to preserve the step-up in basis, which saves your heirs capital gains tax.
- It is a planning tool, not a crisis tool. The best time to set one up is years before you need care.
What is a Medicaid Asset Protection Trust?
A MAPT is an irrevocable trust you create during your life to hold assets you want to protect from the cost of long-term care. Because the trust is irrevocable and you give up the right to reach the principal yourself, Medicaid does not count those assets when it decides whether you qualify, as long as you moved them into the trust more than five years before you apply (42 U.S.C. § 1396p(c), (d)(3)(B)).
You are the grantor. You choose a trustee, usually an adult child or another trusted person, who manages the trust for the people you name as beneficiaries. You typically keep the right to receive income the trust produces, the right to say who ultimately inherits, and often the right to live in a home the trust holds. What you give up is direct control of the principal. That surrender of control is precisely what makes the protection work, and it is why this is a decision to make deliberately and with counsel.
How does a MAPT protect my home and savings from Medicaid?
It protects them in two separate ways: it keeps the assets from counting while you are alive, and it can keep them out of estate recovery after you die.
While you are alive (countability). Medicaid for long-term care has a strict asset limit, just $2,000 for a single applicant in 2026. Assets held in a properly drafted MAPT do not count toward that limit once the five-year look-back has passed, because you can no longer reach the principal.
After you die (estate recovery). This is where Virginia is different, and where most online advice goes wrong. Virginia does not limit Medicaid estate recovery to assets that pass through probate. Under 12VAC30-20-141, the “estate” Virginia can recover from includes not just probate property but “any other real and personal property and other assets in which the individual had any legal title or interest … at the time of his death.” That is called an expanded estate, and it means Virginia can reach non-probate interests.
The practical consequence: a MAPT shields the home from Virginia’s recovery only if you retain no interest that survives to your death. If the trust leaves you a life estate or a right to occupy the home, that retained interest is itself “a legal title or interest at the time of death,” and Virginia can recover against it even after the five years have run. A trust drafted for a probate-only state will not do this correctly in Virginia. Yours has to be built for Virginia’s expanded recovery from the start.
Why won’t a revocable living trust protect my assets?
Because you can revoke it and take the money back at any time, Medicaid treats everything in a revocable living trust as available to you (42 U.S.C. § 1396p(d)(3)(A)). Every dollar counts.
This is the single most common and costly misunderstanding we see. A revocable living trust is a genuinely useful tool: it avoids probate and lets someone manage your affairs if you become incapacitated. But it does nothing to protect assets from the cost of long-term care. If protecting assets from a nursing facility bill is your goal, only an irrevocable trust like a MAPT gets you there. If someone has told you your revocable trust already handles this, it is worth a second opinion before you rely on it.
Wondering whether your current plan actually protects your home?
What do I keep control of, and what do I give up?
You keep more than most people expect, but the surrender of principal is real. Here is the honest split.
You keep: the trust’s income; the right to choose and change your trustee; the right to name and later change who inherits, usually through a retained limited power of appointment; and, if the trust is drafted to allow it, the right to live in a home the trust holds.
You give up: the right to revoke the trust and the right to demand the principal back for yourself. You cannot use a MAPT as a savings account you dip into.
The Virginia wrinkle sits right on top of this trade. The same retained rights that make a MAPT comfortable to live with, a life estate or a right to occupy the home, are the rights that can pull the home back into estate recovery. Balancing comfort against protection is the core of the drafting, and it is not a form you download. It is a judgment your attorney makes with your specific goals in front of them.
Will a MAPT protect the step-up in basis on my home?
Yes, if it is drafted for it. This matters because it can save your heirs a large capital gains tax bill.
When you die, assets included in your estate get a “step-up in basis” to their date-of-death value (IRC § 1014), so your heirs can sell without paying capital gains on the growth during your lifetime. A home you bought decades ago for $60,000 that is worth $400,000 today carries a $340,000 built-in gain. With a step-up, that gain disappears for your heirs. Without it, they inherit your original basis and may owe tax on the difference.
A MAPT can be drafted so the home is included in your estate for this purpose, usually by giving you a retained limited power of appointment (IRC §§ 2036, 2038), which pulls the asset into your estate for basis while creating no estate tax at all (the 2026 federal estate tax exemption is $15 million per person, so a typical family owes none). A generic irrevocable trust without that provision does not deliver the step-up, and the heirs inherit a carryover basis and a tax bill. This is one more reason the drafting details are not optional.
MAPT vs. a life estate deed vs. giving the house to your children
People often reach for a simpler-sounding fix. Here is how the common alternatives compare in Virginia.
| MAPT (irrevocable trust) | Life estate deed | Outright gift to children | |
|---|---|---|---|
| Starts the 5-year look-back | Yes | Yes | Yes |
| Protects home from Virginia estate recovery | Yes, if you retain no recoverable interest | No, the retained life estate is a recoverable interest | Yes, but see risks |
| Preserves step-up in basis | Yes, if drafted with retained powers | Yes, for the remainder | No, children take your basis |
| You keep control of who inherits | Yes | Limited | No |
| Exposed to your child’s divorce or creditors | No | The remainder interest, yes | Yes, fully |
| Reversible if plans change | Limited, but flexible if drafted well | Difficult | No |
The outright gift looks cheapest and is usually the worst: you lose all control, trigger the look-back, hand your child a house exposed to their divorce and creditors, and forfeit the step-up. The life estate deed avoids probate but does not protect the home from Virginia’s expanded recovery. The MAPT costs more up front and does the most, which is why it is the workhorse of Virginia asset protection planning.
When should I set up a MAPT?
As early as you reasonably can. Everything about a MAPT is governed by the five-year clock: the protection only applies to assets that have been in the trust for more than 60 months when you apply. Set the trust up at 65 or 70, well before any health crisis, and by the time care is on the horizon the clock has long since run.
A MAPT is not a crisis tool. If a parent is already in a facility or care is weeks away, the five-year window has not run and a different set of strategies applies. We cover those in our guide to the Virginia Medicaid look-back period, and there are still meaningful options even late in the game. But nothing beats time, and the cheapest move you can make is to plan before you need to.
How much does a Medicaid Asset Protection Trust cost in Virginia?
Because every family’s situation is different, we price Medicaid planning as a flat fee rather than by the hour, so you know the total up front with no surprises. What drives the cost is the complexity of your plan: whether real estate is involved, how many accounts and institutions need to be coordinated, and whether a full irrevocable trust is the right tool for you. Whatever the figure, set it against what is at stake. One month in a Virginia nursing facility runs well over $9,000, and a multi-year stay can consume a lifetime of savings, so for most families the planning pays for itself many times over the first time it shields the home. You can see our current Medicaid planning packages on our Medicaid planning and asset protection page, and you can get a rough read on your own numbers first with our free Virginia Medicaid Runway Calculator.
How Prior Law can help
Medicaid asset protection is one of those areas where the difference between a document that works and one that does not comes down to details a form cannot capture, and in Virginia those details are unusually unforgiving. At Prior Law we build these trusts for Virginia’s expanded estate recovery, coordinate them with the rest of your estate plan, and, because we practice throughout the Shenandoah Valley, we can meet you at your kitchen table rather than making you come to us.
If you want to understand whether a MAPT fits your situation, schedule a Medicaid planning consultation. We will look at your assets, your timeline, and your goals, and tell you honestly whether this is the right tool for you.
Find out whether a MAPT fits your family, honestly and in plain English.
Frequently asked questions
Can I be the trustee of my own MAPT?
Generally no. To keep the assets out of Medicaid’s reach, you should not be the trustee who controls the principal. Most families name an adult child or another trusted person. You keep other meaningful rights, but day-to-day control of the principal has to sit with someone else.
Can I still live in my house if it is in the trust?
Often yes, the trust can be drafted to let you live there for life. In Virginia there is a trade-off: a retained right to occupy the home can expose it to Medicaid estate recovery. Your attorney will structure this to match your priorities.
Can the trust sell the house?
Yes. The trustee can sell a home the trust holds and the proceeds stay in the trust, protected. This is one advantage of a MAPT over a life estate deed, which makes a sale during your life more complicated.
What happens if I need care within five years of setting up the trust?
The transfer into the trust falls within the look-back and can create a penalty period. That is why timing matters so much, and why a MAPT is a planning tool rather than a crisis fix. If you are already close to needing care, talk to us about crisis strategies instead.
Does moving my home into the trust change my property taxes or homestead protections?
Usually the transfer can be structured to avoid a reassessment, but this depends on your locality. We check this before we move any real estate, so there are no surprises on your tax bill.
Can I change who inherits after the trust is set up?
Yes, if the trust gives you a retained limited power of appointment, which most of ours do. You keep the ability to redirect who ultimately receives the assets, even though the trust is irrevocable.
Does a MAPT protect against creditors and lawsuits too?
Assets you no longer own and cannot reach are generally beyond the reach of your future creditors as well, once the transfer is complete. A MAPT is built for Medicaid, but the same features provide a measure of general asset protection.
It is called irrevocable. Does that mean it can never be changed?
Irrevocable means you cannot simply revoke it and take everything back, which is what makes it work. It does not mean it is frozen forever. A well-drafted MAPT includes flexibility, such as the power to change trustees and to redirect inheritances, and Virginia law provides ways to modify irrevocable trusts in limited circumstances.
