A Medicaid Asset Protection Trust (MAPT) is an irrevocable trust used in long-term care planning to keep certain assets from being counted for Medicaid eligibility, while still allowing you to benefit indirectly (for example, continuing to live in your home or receiving investment income depending on the trust terms). Because it’s irrevocable, assets you place in the trust generally can’t be taken back or directly controlled by you. That loss of control is exactly why those assets are usually treated as non-countable for Medicaid after the applicable look-back period has passed. 

Why families use MAPTs

• Preserve the home & savings: Protect a residence or nest egg for a spouse or heirs while planning for future care needs.

• Support Medicaid eligibility: After the look-back window, trust assets are typically not counted toward resource limits for long-term care Medicaid.

• Plan for recovery: Properly structured trusts can help reduce exposure to Medicaid estate recovery after death (state rules vary, get legal advice).

How MAPTs work

1. You create the trust with an elder-law attorney and appoint an independent trustee (not you). The trust is irrevocable.

2. You transfer assets into the trust (often a home, investment accounts, or life savings you don’t need to spend from directly).

3. During your lifetime:
   • You typically can’t access principal (that’s what helps with Medicaid eligibility).

   • You may keep the right to live in your home and, depending on trust design, receive income the trust generates. (Specifics are attorney-drafted.)

4. After the look-back: Trust assets are generally not countable for Medicaid financial eligibility, though income you receive may still be counted under Medicaid’s income rules.

New York rules you should know (2025)

1) Look-back periods

• Nursing Home (Institutional) Medicaid: New York applies a 60-month (5-year) look-back on transfers, including transfers into a MAPT. Gifts/transfers within 60 months can cause a penalty period of ineligibility.

• Community (Home- and Community-Based) Medicaid: New York has planned a 30-month look-back for community-based long-term care but the rollout has been delayed; advocacy updates indicate it was not yet in effect as of early 2025. Always check current status before applying.

2) Transfer-penalty math (nursing home care)

If you move assets into a MAPT within the look-back period and then apply for nursing home Medicaid, NY calculates a penalty period by dividing the value of transfers by the regional nursing home rate the Department of Health publishes each year. The result is the number of months you must self-pay before Medicaid can start. (NY DOH publishes the official annual regional rates.) 

Example (illustrative only): If $149,140 were transferred during the look-back and your region’s monthly rate were about $14,900, the penalty would be 10 months ($149,140 ÷ $14,900 ≈ 10). Use the official DOH rate sheet for the year you apply. 

What assets commonly go into a MAPT?

• Primary residence: Frequently transferred; the trust can let you continue living in the home. Property taxes / STAR benefits depend on local rules, ask counsel.

• Non-retirement investments / savings: Brokerage accounts, CDs, etc. (Income-tax and capital-gains planning are part of the design, speak to counsel/CPA.)

• Life insurance with cash value: Sometimes retitled or addressed via trust ownership/beneficiary changes. 

Often not transferred: Qualified retirement accounts (IRAs/401(k)s) due to tax and distribution issues, handled with different strategies. (Get personalized advice.)

Timing matters: When to set up a MAPT

Because New York’s nursing home look-back is five years, families often implement a MAPT 5+ years before a likely Medicaid application. Waiting until care is urgently needed reduces options and can trigger penalties. 

MAPT pros & cons (quick scan)

Advantages

• Preserves a home or nest egg for a spouse/children.

• Positions you for Medicaid after look-back ends.

• May mitigate Medicaid estate recovery exposure. 

Trade-offs

• Irrevocable: You give up direct control over the trust principal.

• Up-front legal fees and careful drafting required.

• Transfers inside the look-back can create penalties. 

How we help

• Plain-English planning: We explain MAPTs, look-back timing, and how it fits your care plan.

• Attorney coordination: We’ll connect you with vetted New York elder-law counsel to draft the trust.

• Care-first budgeting: We pair legal planning with a realistic home-care cost plan (see our “Budgeting for Long-Term Care at Home” guide next).

• Application support: When you’re ready, we guide you through the Medicaid process and provider selection.

Important: This guide is educational and not legal or tax advice. Always consult a NY elder-law attorney and tax professional before transferring assets.