Medicaid Planning: A Critical Step to Protect Your Family’s Financial Future

As more Americans face the rising costs of long-term care, families are asking a pressing question: How do we protect a lifetime of savings from being spent on nursing home expenses? The answer lies in proactive Medicaid planning, a legal and financial strategy that can help preserve assets while ensuring access to necessary care.

At Legacy Design Strategies, we work with Omaha individuals and families to navigate the complex Medicaid system, offering tailored solutions that protect what matters most. Here's what you need to know to make informed choices before a crisis hits.

What Is Medicaid, and Why Is Planning So Important?

Medicaid is a government program designed to provide healthcare coverage to individuals with limited income and resources, particularly for long-term care services that Medicare doesn’t cover.

As our elder lawyers at Legacy Design Strategies find that people often confuse Medicaid with Medicare. While Medicare covers short-term medical needs, it does not pay for long-term nursing home care. Medicaid steps in only if strict health and financial qualifications are met.

To qualify for Medicaid:

• A person must need assistance with daily activities such as bathing, dressing, or eating—or have cognitive impairments like Alzheimer’s.
• They must also meet stringent financial requirements, including asset and income limits that vary depending on marital status and state regulations.

These rules are complex, and small missteps can delay or deny Medicaid coverage in Nebraska. That’s why planning ahead with a trusted estate planning attorney is essential. Read more on Medicaid and Estate planning in our article, What's the Difference Between Medicaid Planning and Estate Planning?

The Risk of Nursing Home Costs Without Medicaid Planning

Long-term care is one of the most significant financial threats facing older adults today. Nursing home costs can exceed $100,000 per year, and many families falsely assume Medicare will cover these expenses.

Without proper Medicaid planning, families in Omaha often face heartbreaking choices:

• Selling the family home
• Draining retirement accounts
• Leaving a healthy spouse with few resources
• Losing assets meant for children or future generations

Read more on protecting your assets from nursing home costs in our article, How Do I Keep My Assets from the Nursing Home

Smart Medicaid Planning Strategies to Protect Assets

1. Medicaid Asset Protection Trusts (MAPTs)

By transferring assets into a MAPT at least five years before applying for Medicaid, families can legally shield wealth from asset calculations. These trusts remove assets from an individual's name while still allowing some control over how they are distributed later.

2. Spousal Protections

If only one spouse needs care, Medicaid allows the community spouse to keep a portion of the couple’s assets and income. Strategic legal planning ensures these protections are maximized.

3. Exempt Asset Planning

Certain assets—such as a primary residence up to a specified value—are not counted for Medicaid eligibility. However, improper transfers or titling can still put them at risk. Proper legal documentation is crucial to safeguard them.

4. Gifting and Transfers with Caution

Many families consider gifting assets to children to reduce countable wealth. However, Medicaid enforces a five-year "look-back" period on asset transfers. Improper gifts can trigger a penalty period, delaying care coverage. Instead, structured transfers or trusts offer safer alternatives.

Is Long-Term Care Insurance a Better Option in Omaha?

For those who plan early, long-term care insurance may help offset the costs of in-home or nursing facility care. However, premiums rise with age and many older adults don’t qualify due to health restrictions. For this reason, Medicaid remains a vital part of most families' long-term care strategy—especially when guided by an experienced attorney.

Steps to Take Now to Prepare for Medicaid Eligibility in Nebraska

Waiting for a health crisis limits your options. Here’s what families can do now to prepare:

• Assess Assets and Care Preferences – Take inventory of finances and clarify care wishes.
• Meet with an Omaha Medicaid Planning Attorney – Legacy Design Strategies can help build a plan that meets your family’s needs.
• Review Estate Planning Documents – Ensure wills, powers of attorney, and healthcare directives align with your long-term care goals.
• Discuss the Plan with Family – Open conversations prevent confusion and strengthen support systems.

Why Work with Legacy Design Strategies for Medicaid Planning?

At Legacy Design Strategies, we help Omaha-area families as well as families in Minot, ND, and Iowa Falls, IA protect their financial future through thoughtful, customized Medicaid planning. Our team understands that every situation is different, and we’re committed to helping you navigate the system with clarity and compassion. Ready to plan ahead for your parents or yourself? Request a Consultation with our team. 

Key Takeaways

• Medicaid is the primary payer for long-term care, but qualifying requires careful planning.
• Without Medicaid planning, families may be forced to liquidate savings and assets to pay for care.
• Tools like MAPTs, spousal protections, and exempt asset planning can preserve wealth.
• Early planning provides the best chance to secure care and protect your legacy.

Start your Medicaid planning journey today with Legacy Design Strategies—and protect what you’ve worked a lifetime to build.

Reference: Elder Law Answers (Jan. 16th, 2025) "Protecting Your Parents' Assets from Nursing Home Costs"