Long-Term Care Planning & Medicaid Eligibility

Christopher M. Woodfin, Esq.

Expert Contributor | Zaremba Center for Estate Planning & Elder Law

Gloucester Living Jan 2026

Planning Today to Protect Tomorrow

When facing long-term care — whether at home, in assisted living, or in a skilled nursing facility — the planning you do now, matters. At Zaremba Center, we focus on helping you navigate the complex system of Medicare, Medicaid, income & asset eligibility, and protection strategies, so that you can protect your legacy, preserve as much of your estate as possible, and secure the care you or a loved one needs.

Why Long-Term Care Planning Matters

Many families assume that Medicare will cover long-term care—however, Medicare pays for limited, short-term care and does not cover most extended nursing home or assisted living stays.
Medicaid can cover long-term care services in many cases—if eligibility requirements are met. Without planning, assets may be spent down, leaving little for heirs.
With thoughtful planning—income structuring, asset transfers, trusts—you may qualify for Medicaid sooner and protect more of your assets.
The stakes are high: long-term care costs are substantial and rising. Waiting until needs are urgent often means fewer options and greater stress on families.

Understanding the Basics: Medicare vs. Medicaid

Medicare: A federal program for people 65+ (or certain younger people with disabilities). Covers many health care expenses—but not most long-term custodial care (help with bathing, dressing, living assistance) over the long term.
Medicaid: A combined federal/state program for low-income individuals who meet eligibility standards. Medicaid can pay for long-term care in a nursing home if the person meets both the medical and financial requirements. In Virginia, Medicaid can also cover some assisted living and in-home care services, if eligibility requirements are met.

Financial Qualification: Income, Assets & Approval

Assets

To qualify for Medicaid, your “countable” assets must generally fall below state-specific limits. Some assets are exempt, while others count toward the limit.
Without proper planning, you might have to liquidate savings, investments, or property to pay for care—even though you hoped to pass those assets to your loved ones.

Income

Similarly, income plays a key role. If your income is above a threshold, Medicaid may not approve until you arrange it appropriately.

Approval Timing & Process

Applying for Medicaid is often time-sensitive. Waiting too long can reduce your ability to protect assets.
Some transfers or gifts made too recently may incur a “penalty period” before Medicaid benefits apply.
Working with an experienced elder-law attorney can make the difference between approval and denial, timely benefits vs. delay.

Asset Protection Strategies: Medicaid Asset Protection Trusts & More

At Zaremba Center, we help you explore and execute strategies that may include:

Establishing a Medicaid Asset Protection Trust (MAPT) or other irrevocable trusts to shelter assets while meeting eligibility.
Re-titling assets, changing ownership, or converting countable assets into exempt forms.
Structuring income to meet the Medicaid rules while preserving quality of life.
Coordinating your long-term-care plan with your overall estate plan so that your goals can be met: care, control, legacy.

These strategies must be tailored to Virginia (and regional) rules, executed carefully to avoid unintended consequences.

How We Help You at Zaremba Center

Call and schedule your consultation TODAY – We’ll sit down with you (or your loved one) to review your current situation: health status, care needs, finances, assets, and goals.
Eligibility review – We assess Medicaid rules, timing, state regulations, potential penalty periods, and your options.
Plan design & implementation – We prepare the legal documents (trusts, asset transfers, powers of attorney), guide you through income and asset structuring, and coordinate with other advisors (financial, tax, care providers).
Ongoing support – Long-term care planning is not “set it and forget it.” We monitor changes in regulations, your health or care needs, and your financial picture to adjust as needed.

When to Act

The earlier you engage in long-term care planning, the more options you have. Once care is urgent, or assets are already expended, your flexibility may be lost. If you or your loved one are entering a skilled-nursing environment, facing assisted living, or simply want to protect your hard-earned assets and ensure quality care, now is the time.

Let’s Talk

Don’t wait until a health crisis forces rushed decisions. Let the team at Zaremba Center guide you through this critical planning stage—so you can focus on what matters: care, comfort, dignity, and leaving a legacy.