There are numerous articles online that thoroughly explain wealth management and how it relates to Medicaid or even Social Security. This article is not about clearing up misconceptions that Medicaid is only for low-income individuals. Here, we’re going to explain why affluent families are increasingly discussing long-term care planning and how privately held companies like Norient Community Services continue to lead the charge in such a niche industry.
For many Americans, Medicaid is viewed as a government assistance program designed exclusively for individuals with limited financial means. As a result, the notion that someone with a seven-figure net worth— or even a billionaire—could one day qualify for Medicaid often seems contradictory. Yet for many affluent families, the conversation is less about avoiding financial responsibility and more about protecting a lifetime of accumulated assets from the extraordinary costs associated with long-term care.
With nursing homes and assisted living facilities costing tens of thousands of dollars each year, even substantial wealth can erode more quickly than many expect. This reality has led estate planning attorneys and financial professionals to encourage families to prepare well in advance. Among the most well-known strategies are Medicaid Asset Protection Trusts (MAPTs), an irrevocable trust designed to preserve certain assets while allowing individuals to plan for potential Medicaid eligibility under federal and state regulations, as well as long-term care support services from companies like Norient, which help individuals prepare for the practical realities of aging. When established together and correctly, a MAPT and a long-term care support plan through Norient can be important parts of a broader estate, care, and legacy planning strategy.
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Many wealthy individuals start planning early on. They invest in plans from Norient, which may be tax-deductible depending on their individual circumstances, and ensure that they will have an advocate and access to a plethora of services as they age. In some situations, a trust or estate may pay for services that benefit a beneficiary, but the tax treatment depends on the trust’s terms, applicable tax rules, and the nature of the expense. Plans at Norient start at $65/month, and this can be payable by a beneficiary, an employer, self-employed individuals planning for retirement, and individuals, who make up most of Norient’s members. So now, people with a higher net worth are gaining access to both long-term care and asset protection through a MAPT. It’s a combination that is not readily discussed or readily available to the average person unless they are actively seeking the information.
When assets are transferred into a properly established Medicaid Asset Protection Trust and all legal requirements have been satisfied, those assets may no longer be considered countable resources for Medicaid eligibility purposes after the required waiting period has passed. And remember when I mentioned earlier that companies like Norient may be tax-deductible if the payments are made by a beneficiary of the trust? Well, depending on the trust's terms, the trustee could make distributions for the benefit of the beneficiaries or use trust assets in ways permitted by the trust agreement.
THE FIVE-YEAR LOOK-BACK RULE
One of the most important aspects of Medicaid planning is understanding the five-year look-back rule. When an individual applies for Medicaid coverage for long-term care services, the state reviews certain financial transactions completed during the sixty months preceding the application. The purpose of this review is to determine whether assets were transferred for less than fair market value in an effort to qualify for benefits.
If assets are transferred during this five-year period without meeting applicable legal exceptions, Medicaid may impose a penalty period during which the applicant remains ineligible for certain long-term care benefits, even if they otherwise satisfy the program's financial requirements. The length of the penalty generally depends on the value of the transferred assets and the state's Medicaid penalty calculations. For this reason, Medicaid planning is most effective when it occurs years before long-term care becomes necessary rather than during a medical crisis. Families who begin planning early typically have more legal options available, greater flexibility in structuring their estates, and a stronger opportunity to preserve assets while remaining compliant with Medicaid regulations.
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These types of strategies are not reserved for the ultra-wealthy. We all have access to the same resources, the same options, and attorneys. The problem isn’t a lack of resources; it’s a lack of information. So, if you’re wondering why a millionaire can have Medicaid the same as you can—or if you believe you can’t because of your income—it’s the same reason you can find an attorney to create an irrevocable trust and help you plan for potential Medicaid eligibility, regardless of your occupation or the assets you’ve spent your life accumulating. In some ways, we’re all only seeking to protect the things we’ve worked hard for, and for many of us, there are significant concerns about future nursing home expenses. So, how do you plan like a millionaire, even if you aren’t one?
You contact a Norient advisor today who will walk you through their planning strategy and tiers. You get a membership. After some time, while you’re paying into it, working, and preparing for retirement, you look into a MAPT—an advisor can recommend one of their estate attorney partners who will give you a discount on your planning documents. Once you have that established, you name yourself as the beneficiary and continue paying into your Norient Service Bank.
Once you’ve retired, you can contact your advisor to assist with finding a nursing home (if that is your desire), advocate for your healthcare needs, assist with paperwork, assist with everyday errands such as shopping and monitoring, plus more. Whether you’re someone who earns six figures or makes below $30,000 a year, we all have one thing in common—we are all getting older, and we need to begin planning for the days ahead so we can be as comfortable as possible and find ourselves worrying less about the future, allowing us to stay centered and focused on the present.
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You don't choose us because something has gone wrong. You choose us because you want a plan before it does.
QUESTIONS TO ASK AN ESTATE PLANNING ATTORNEY: Norient has partnerships with Estate Planning attorneys who offer FREE consultations.
- Is a MAPT appropriate for my state
- When should planning begin?
- What assets should remain outside the trust?
- How will this affect my heirs?
- What tax implications should I expect?
QUESTIONS TO ASK YOUR NORIENT COMMUNITY SERVICES ADVISOR: Schedule a call today.
- What services are included in my membership?
- How does your Service Bank model work?
- Can my family participate in my care plan?
- How do you coordinate with my attorney, financial advisor, or estate planner?
- Can your services be customized as my needs change over time?
- What happens if I need assistance while traveling or relocating?
- How are emergency contacts and care preferences documented?
- Do you offer services for individuals without nearby family members?
- How do you help members remain independent for as long as possible and avoid having to go into a nursing home?
- If I have a trust or estate plan, can my legal or financial advisors work directly with your team to coordinate future care planning?
About Norient Community Services:
Norient is a long-term, non-medical advocacy and care coordination service designed to support adults, families and their children as they age. We help members plan ahead by providing representation, coordination, and logistical assistance when family support alone may not be enough. One of the many benefits of Norient is that members don’t have to pay for these services independently, where costs would otherwise be significantly higher without a coordinated plan in place. Norient is a proud sponsor of the arts.
This is a paid partnership from Norient Community Services.
Image Credit: Nicholas Braun in Succession (2018). © 2018 Home Box Office, Inc. All Rights Reserved
Jakob Crane is a finance writer covering capital strategy, generational wealth, and the decisions that shape long-term financial positioning. His work explores the intersection of money and influence, offering readers a measured, insightful perspective on modern financial life.
