The cost of long-term care in Ohio is staggering - nursing home care averaged over $8,750 per month in 2025. Without proper planning, even a lifetime of savings can be depleted in just a few years. Medicaid can help cover these costs, but qualifying requires meeting strict income and asset limits. Fortunately, there are legal strategies to protect your assets while ensuring access to the care you need.

Below, we explore the most effective long-term care planning techniques in Ohio, how they work, and real-world examples for both singles and married couples.

1. Medicaid Asset Protection Trusts (MAPTs)

What Is a MAPT?

A Medicaid Asset Protection Trust is an irrevocable trust designed to remove assets from your name so they are not counted for Medicaid eligibility. Once assets are transferred into the trust and the five-year lookback period has passed, those assets are protected from Medicaid spend-down requirements.

Key Features

• Irrevocable: You cannot revoke or reclaim assets once transferred and the terms of the trust cannot be changed once set.
• Someone else serves as the Trustee of the trust.
• Income-Only Option: You may receive income generated by trust assets, but not the principal.
• Home Protection: You can continue living in your home while it’s in the trust.
• Estate Recovery Shield: Assets in the trust are generally protected from Medicaid estate recovery after death.

Example: Married Couple

Richard and Martha, ages 75 and 73, own a home worth $350,000 and have $650,000 in savings and investments. They create a MAPT and transfer their home and $230,000 in investments into the trust. Their daughter serves as trustee. Six years later, Richard needs nursing home care. Because the five-year lookback has passed, the assets in the trust (now worth $680,000) are not counted for Medicaid eligibility. Richard qualifies for Medicaid, and Martha retains financial security.

Example: Single Individual

Sarah, age 75, owns a $200,000 home and $150,000 in savings. She sets up a MAPT and transfers her home and $100,000 into the trust. After five years, she needs nursing home care. Medicaid ignores the trust assets, allowing Sarah to qualify without losing her home or savings earmarked for heirs.

2. Medicaid-Compliant Annuities (MCAs)

What Is an MCA?

A Medicaid-Compliant Annuity converts countable assets into an income stream, which can help you qualify for Medicaid immediately, even in a crisis. Unlike gifts or transfers, purchasing an MCA does not trigger a penalty period if structured correctly.

Ohio Requirements

• Irrevocable and Non-Assignable
• Immediate Payments (no deferral)
• Equal Payments over a term not exceeding life expectancy
• State of Ohio Named as Remainder Beneficiary
• Issued by a Commercial Insurance Company

Example: Married Couple

John and Mary have $300,000 in countable assets and John needs nursing home care. Medicaid allows Mary (the community spouse) to keep $148,620 as her Community Spouse Resource Allowance (CSRA). The remaining $149,380 would normally need to be spent down. Instead, Mary uses it to purchase an MCA, which pays her $2,075 per month for eight years. John qualifies for Medicaid immediately, and the couple preserves nearly $200,000.

Example: Single Individual

Sarah has $102,000 in assets and needs care now. She buys an MCA for $100,000 with a four-year term, generating $2,083 per month. Medicaid covers the difference between her income and care costs. If Sarah passes away after two years, her heirs receive the remaining payments (after Ohio’s recovery claim).

3. Protecting the Home

For many Ohio families, the home is their largest asset. Medicaid rules allow some protections:

• Married Couples: If one spouse remains in the home, it is exempt while they live there.
• Singles: The home is exempt for 13 months after entering a nursing home, but then Medicaid may require its sale unless it’s protected through a trust or other planning strategy.

Which Strategy Is Right for You?

• Advance Planning (5+ years before care): MAPTs are ideal for those who want to protect significant assets and plan ahead.
• Crisis Planning (Care Needed Now): Medicaid-Compliant Annuities can protect assets quickly for couples and sometimes singles.
• Homeowners: Combining a MAPT with other tools ensures your home stays in the family.

Final Thoughts

Every family’s situation is unique. The right strategy depends on your assets, health, and timing. Working with an experienced Ohio elder law attorney is essential to avoid costly mistakes and ensure compliance with Medicaid rules. Use the link to download our Long-Term Care Guide, and when you’re ready to meet with us, you can request an appointment from our website as well.