To properly assist clients, elder law attorneys must juggle knowledge of multiple public benefits programs, each with its own unique eligibility requirements. Additionally, attorneys must stay informed about the distinctions among the various planning strategies and legal instruments available.

This blog provides a definitional foundation and an up-to-date reference for the current year’s figures. It is intended as a supplement to your own research and should not be considered legal advice.

Medicaid

A needs-based, means-tested government healthcare assistance program administered jointly by federal and state governments.

Who qualifies?
Individuals, couples, and families with limited income and assets (generally, $2,000 or less in most states). Medicaid also generally covers indigent children, pregnant women, and individuals living with a disability, including those who are institutionalized.

Important notes:

• Medicaid rules vary significantly by state.
• The median nationwide nursing home cost for a private room is $10,646 per month (2025).
• Planning is advised at least five years before seeking Medicaid eligibility; use of a Medicaid Asset Protection Trust (MAPT) is the best practice for asset preservation.
• States must recover benefits paid from a deceased beneficiary’s estate.
• Consultation with an elder law attorney is recommended in both crisis and proactive planning situations.
   

Medicaid Asset Protection Trust (MAPT)

A self-settled irrevocable trust designed to hold assets in a manner that satisfies strict Medicaid eligibility standards while thoughtfully preserving a client’s assets for final distribution.

For whom is it used?

• Individuals proactively planning to protect assets from future long-term care costs and estate recovery.
• Individuals seeking immediate Medicaid eligibility through crisis planning.

Important notes:

• Assets placed in a MAPT are not subject to Medicaid eligibility assessment after five years have passed.
• Gifts to a MAPT may trigger a transfer penalty; thus, MAPTs must be carefully drafted under elder law attorney supervision.
• Best practice tool for Medicaid planning.
   

Medicare

A federal health insurance program with four parts:
(1) Hospital Insurance, (2) Medical Insurance, (3) Medicare Advantage, and (4) Prescription Drug Coverage.

Who qualifies?

• Individuals age 65 and older.
• Persons under 65 receiving SSDI for at least two years.
• Individuals with end-stage renal disease or Lou Gehrig’s disease (ALS).

Important notes:

• Part A: Inpatient care, hospice, short-term skilled nursing care.
• Part B: Outpatient care, medical equipment, preventive services.
• Part C: Medicare Advantage Plans.
• Part D: Prescription drugs.

Supplemental Security Income (SSI)

A means-tested program administered by the Social Security Administration (SSA) providing financial support for basic necessities.

Who qualifies?

• Disabled individuals meeting the SSA definition of disability.
• Seniors age 65 and older, all of whom must meet strict income and asset limits.

Important notes:

• SSI recipients often qualify for Medicaid.
• The 2025 maximum monthly benefit is $967 (individual) and $1,450 (couple).
• Some states provide an SSI supplement.

Social Security Disability Insurance (SSDI)

A public insurance program providing monthly benefits to disabled workers.

Who qualifies?

• Disabled workers who have accumulated sufficient work credits and meet SSA medical criteria.

Important notes:

• SSDI is not means-tested.
• Medicare eligibility typically begins two years after SSDI payments start.
• The 2025 maximum monthly benefit is $4,018.

Special Needs Trust (SNT)

A trust designed to preserve public benefits while providing supplemental resources to a disabled individual.

For whom is it used?

• Disabled individuals receiving public assistance.
• Beneficiaries requiring asset protection to maintain eligibility for means-tested programs.

Important notes:

• First-party SNTs (also called d4A trusts) are funded with the beneficiary’s own assets, must include a Medicaid payback provision, and protect eligibility.
• Third-party SNTs are funded with assets of others, require no Medicaid payback, and should be part of proactive estate planning.

SECURE Special Needs Trust (SSNT)

A specialized third-party SNT created to hold retirement assets under the SECURE Act for the benefit of a disabled or chronically ill beneficiary.

For whom is it used?

• Retirement account holders seeking to leave an inheritance to a disabled or chronically ill beneficiary without disrupting public benefits eligibility.

Important note:

• SSNTs must designate the disabled or chronically ill individual as the sole lifetime beneficiary.

Supplemental Nutrition Assistance Program (SNAP)

Federal nutritional assistance program (formerly known as food stamps).

Who qualifies?

• Households with limited resources, including seniors (age 60+) and disabled individuals who meet financial criteria.

ABLE Account

A tax-advantaged savings account for disabled individuals that allows savings without losing eligibility for means-tested benefits.

Who qualifies?

• Individuals who acquired a disability before age 26, who receive SSI or SSDI, or meet SSA disability criteria.

Important notes:

• 2025 annual contribution limit: $19,000.
• The first $100,000 is exempt from SSI resource limits (higher thresholds for Medicaid).
• Starting January 1, 2026, the disability onset age limit increases to 46 years old.

Veterans Affairs (VA) Pension (Aid and Attendance)

Financial assistance for wartime Veterans and surviving spouses to help cover long-term care costs.

Who qualifies?

• Veterans who served at least 90 days of active duty (including one wartime day), meet medical and financial eligibility, and satisfy transfer rules.

Important notes:

• 2025 maximum monthly tax-free benefits: $2,795 (married Veteran), $2,358 (single Veteran), $1,515 (surviving spouse).
• Three-year look-back for asset transfers.
   

Veterans Asset Protection Trust (VAPT)

A self-settled irrevocable trust used to protect assets for VA Pension (Aid and Attendance) eligibility.

For whom is it used?

• Wartime Veterans and their spouses, especially those with a primary residence to protect.

Important notes:

• VA transfer rules differ from Medicaid rules.
• VAPTs are considered best practice for VA pension eligibility planning.

Combat-Related Special Compensation (CRSC)

Tax-free monthly support for Veterans with combat-related disabilities.

Who qualifies?

• Military retirees with at least 20 years of service or under specific retirement/disabled lists who have combat-related injuries.

Concurrent Retirement and Disability Pay (CRDP)Payment restoring retired pay for disabled military retirees with VA disability ratings of 50% or higher.

Who qualifies?

• Military retirees with 20+ years of service and a VA service-connected disability rating of at least 50%.

Final Note

This guide serves as a useful reference for elder law attorneys and professionals assisting clients with public benefits and asset protection strategies. Always consult applicable regulations and experienced counsel for case-specific guidance.