Five Common Medicaid Planning Mistakes and How to Avoid Them
Posted on August 11, 2025 by shieldsandboris
The cost of long-term care is extreme. Even a semi-private room in a nursing home in Western Pennsylvania can run well over $100,000 per year. Medicaid can help cover the high cost of long-term care. With that being said, Medicaid is a strictly means-tested program that requires a strong, well-structured plan. Here, our Pennsylvania asset protection lawyer highlights five of the most common Medicaid planning mistakes and discusses the strategies to help you avoid them.
Planning to Rely on Medicare (Not Medicaid) for Long-Term Care Support
Many aging adults and senior citizens mistakenly assume that Medicare will cover long-term care needs. Unfortunately, this is simply not the case. In reality, Medicare only pays for limited, short-term skilled nursing care after a hospital stay. The Pennsylvania Department of Human Services (DHS) clarifies that Medicaid (not Medicare) is the primary government program that helps pay for nursing homes and other long-term care services. It is a big difference because Medicaid is strictly means-tested. Confusing the two can leave families unprepared and struggling to cover the high cost of extended care.
How to Avoid it: You need to know how long-term care coverage in the United States actually works in practice. Understanding the differences between Medicare and Medicaid is key. If long-term care is a possibility, begin planning for Medicaid eligibility early: even before you need it. You should work with a trusted elder law attorney to explore legal strategies that protect your assets while preserving your eligibility for care. A proactive approach can help you protect your best interests.
Waiting Too Long to Put a Medicaid Plan in Place
Medicaid planning is not something to put off until the need for long-term care is urgent. That is one of the biggest mistakes that you can make. Sadly, too many families wait until a loved one is already in poor health or about to enter a nursing home. At that point, you and your family will only have some limited options available. The five-year look-back rule may already be in effect. You or your loved one could be forced to “spend down” assets before being able to access Medicaid benefits.
How to Avoid it: The best strategy is to begin long-term care planning as early as possible. Indeed, you should start long-term care planning while you or your loved one is still healthy. The earlier you start, the more tools you have to protect assets and structure eligibility properly. Even if you are not sure care will be needed, early planning creates a safety net. A Pennsylvania elder attorney can help.
Failing to Take Full Advantage of the Benefits Provided By a Trust
Trusts are one of the most powerful tools available for Medicaid planning. There is a common misconception that trusts are truly only useful for the very rich. However, when it comes to Medicaid planning, that is simply not the case. If you use them correctly, trusts can be a very effective estate planning strategy to protect against long-term care costs. Without the right kind of trust, assets may be exposed to nursing home costs. Even a short-term period of long-term care needs can quickly deplete a person’s life savings.
How to Avoid it: The right time to speak to an elder law attorney about trusts is as soon as possible. You should consult a qualified Pennsylvania elder law attorney to discuss whether a Medicaid Asset Protection Trust (MAPT) or another trust arrangement is right for your situation. When done correctly, these trusts can shield assets from long-term care costs while still preserving Medicaid eligibility.
Giving Away Assets Without Understanding the Look-Back Period
Some people try to qualify for Medicaid by giving away money or property to family. That could be a viable strategy, but it needs to be done with care. If transfers occur within five years of applying for Medicaid, they may trigger a penalty period. It is a big problem because it could delay benefits and leave the applicant (vulnerable person) without coverage during a time of urgent need. Even seemingly innocent gifts (like helping a grandchild with college) can have unforeseen consequences.
How to Avoid it: Never give away assets without first consulting a Medicaid planning professional. A knowledgeable attorney can help you make legal, penalty-free transfers or use strategies like irrevocable trusts. If you have already made gifts, there may still be ways to mitigate the penalty. The best approach is to try to make any transfers outside of the five-year lookback period.
Not Seeking Professional Support for a Pennsylvania Top Elder Lawyer
Medicaid planning is complex. Laws are always changing. Further, Pennsylvania has its own specific rules in addition to the federal regulations. Attempting to navigate the process alone can be difficult. It is generally a big mistake not to get help from a reliable attorney.
How to Avoid it: Consult with a Pennsylvania elder law attorney who has experience with long-term care planning and Medicaid crisis planning. top elder lawyer will evaluate your unique situation, explain your options in plain language, and create a personalized strategy to best protect you and your family.
Why Trust Our Pennsylvania Elder Law Attorney
Medicaid planning is complicated. A proactive approach is the best approach. At The Elder Law Offices of Shields & Boris, we are committed to helping clients find the best solution for their specific situation. Our team evaluates every possible strategy for developing a long-term care plan so that you are in the very best position to protect your assets. An initial consultation with our Pennsylvania Medicaid planning attorney is confidential.
Contact Our Pennsylvania Medicaid Planning Lawyer Today
At The Elder Law Offices of Shields & Boris, our Pennsylvania estate planning and elder law attorneys are leaders in asset protection. Long-term care planning mistakes are relatively common. You do not have to make them. If you have any questions or concerns about Medicaid planning, we can help. Give us a call at (724) 204-6628 or contact us online to arrange a fully confidential consultation. Our firm provides Medicaid planning services throughout Western Pennsylvania.
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