The cost of setting up an asset protection trust ranges from $1,500 to $5,000 or more, depending on your state, the complexity of your assets, and whether you use an attorney

A Medicaid asset protection trust (also called a Medicaid may have access to trust) is a legal document that moves assets into a trust structure so they do not count toward Medicaid's asset limits. The cost to create one is not a government fee — it is what you pay an attorney to draft the trust document and handle the paperwork. There is no single price because attorney fees vary by location, and the complexity of your situation affects how long the work takes.

Most people pay between $1,500 and $5,000 for a straightforward trust. If your assets are complicated — multiple properties, business interests, or accounts in different states — the cost can reach $7,000 to $10,000 or higher. Some attorneys charge a flat fee for a basic trust; others bill hourly. A few legal aid organizations or elder law clinics offer reduced-cost or sliding-scale services if your income is low.

Key Takeaways

  • Attorney fees for a Medicaid asset protection trust typically run $1,500 to $5,000, with complexity and location driving the price up or down.
  • You pay the attorney directly; there is no government filing fee or Medicaid charge to create or maintain the trust.
  • The trust must be irrevocable and created at least five years before you apply for Medicaid long-term care coverage, or the assets may still count against you.
  • Some states have specific trust rules that affect cost — an attorney licensed in your state can tell you whether your situation qualifies and what the actual price will be.
  • Legal aid organizations, law school clinics, and some elder law attorneys offer reduced fees based on income; call your local bar association or legal aid office for referrals.

What the attorney fee actually covers

When you pay an attorney to set up a Medicaid asset protection trust, you are paying for the time to draft the trust document, review your financial situation, explain how the trust works, and file or record the document if your state requires it. The attorney also typically handles the paperwork to transfer assets into the trust — changing the title on a house, for example, or updating bank account registrations.

The fee does not include ongoing management of the trust. Once the trust is created, you or a trustee you name manages the money inside it. If you need the attorney to help with that later — answering questions, handling distributions, or dealing with tax forms — that is usually billed separately at hourly rates, which range from $150 to $400 per hour depending on the attorney's experience and your region.

Why the cost varies so much

Location is the biggest driver of cost. Attorneys in rural areas or states with lower costs of living typically charge less than those in major cities. An attorney in rural Kansas might charge $1,500 for a basic trust; the same work in New York City or San Francisco could cost $4,000 or more.

Complexity matters too. If you own a house, a car, and a savings account, the trust is straightforward. If you own rental property, a small business, accounts in multiple states, or have a blended family with complicated wishes about who gets what, the attorney has to spend more time understanding your situation and drafting language that covers all of it. That time translates to higher fees.

The type of fee structure also affects what you pay. Some attorneys quote a flat fee for a basic Medicaid trust — you know the price upfront. Others bill hourly, which means the final cost depends on how long the work takes. A few offer package deals that bundle a trust with a will or power of attorney at a discount.

The five-year waiting period and why timing matters

A Medicaid asset protection trust only works if you create it at least five years before you apply for Medicaid long-term care coverage. This is called the look-back period. If you create the trust and apply for Medicaid within five years, Medicaid will count the assets you moved into the trust as if they were still yours, and you may not may have access to.

This timing rule means the cost of the trust is not just the attorney fee — it is also the cost of planning ahead. If you wait until you are already in a nursing home or need care soon, a trust may not help you at all. Some people spend $2,000 on a trust that cannot protect their assets because they did not plan far enough in advance. That is why elder law attorneys often recommend creating a trust while you are still healthy and can think clearly about your finances.

Reduced-cost and free options

If you cannot afford a private attorney, several resources offer lower-cost help. Legal aid organizations in your county provide free or sliding-scale legal services to people with low income. Call your local legal aid office or search online for "[your county] legal aid" to find out whether you may have access to and whether they handle Medicaid planning.

Some law schools run elder law clinics where law students, supervised by licensed attorneys, help older adults with estate planning and Medicaid issues at little or no cost. Your local bar association can refer you to clinics in your area. A few elder law attorneys also offer reduced fees on a sliding scale based on your income.

Be cautious of online legal document services that promise to create a trust for $200 or $300. These services provide a template document, not legal advice tailored to your situation. Medicaid rules are state-specific and complex; a generic template may not protect your assets the way you need, or it may create tax problems later. If you use an online service, have a local attorney review the document before you sign it — that review typically costs $300 to $500 and is usually worth it.

What happens after you create the trust

Once the trust is created and funded (meaning your assets are transferred into it), there are no ongoing government fees or Medicaid charges. You do not pay Medicaid to maintain the trust or to keep your assets protected. However, a trust may have tax implications. If the trust generates income — rent from a property, interest on money held in the trust — you may owe income tax on that money. The trustee typically files a tax return for the trust each year, which costs $200 to $500 depending on the complexity.

You also need to keep records showing that the trust was created and funded properly. When you apply for Medicaid, you will have to provide copies of the trust document, proof that assets were transferred into it, and documentation of when the transfer happened. Having organized records from the start makes the Medicaid application much simpler.

Comparing a trust to other Medicaid planning strategies

An asset protection trust is one way to reduce countable assets, but it is not the only way. Some people use a spend-down strategy instead — they spend their money on allowed expenses like home repairs, medical care, or paying off debt, which reduces their assets without creating a trust. A spend-down costs nothing except the money you spend, but it requires careful planning to avoid mistakes that Medicaid will penalize.

Others use a Medicaid caregiver agreement, which pays a family member for care they provide. This reduces assets by converting them to wages, and it costs only what you pay the attorney to draft the agreement — usually $500 to $1,500. The trade-off is that it only works if a family member is actually providing care, and Medicaid scrutinizes these agreements closely.

An attorney who specializes in elder law can review your specific situation and tell you which strategy — or combination of strategies — makes sense for you. That consultation typically costs $200 to $400 and can save you thousands by pointing you toward the most effective approach.

Frequently Asked Questions

Can I set up a Medicaid asset protection trust myself without an attorney?

You can download a trust template online and sign it yourself, but Medicaid rules are state-specific and the trust must be drafted correctly or it will not protect your assets. If the trust is flawed, you may spend money on it and still lose your assets to Medicaid. Most people find that paying an attorney upfront to do it right is cheaper than fixing a mistake later.

Does Medicaid charge a fee to review my trust when I apply?

No. Medicaid does not charge you to review a trust or to determine whether it protects your assets. The only cost is what you paid the attorney to create it. Medicaid staff will examine the trust document and the dates you transferred assets into it, but there is no fee for that review.

What if I create a trust but then need to change it?

If the trust is irrevocable — which it must be for Medicaid purposes — you generally cannot change it without court permission, and that is expensive and complicated. This is why it is important to think through your wishes carefully before you create the trust. If you need to modify an irrevocable trust, an attorney can tell you whether it is possible and what it will cost, usually $1,000 to $3,000 or more.

Will a trust protect my assets from a nursing home bill if I create it less than five years before I apply?

No. Medicaid's five-year look-back period means that if you create a trust and apply for Medicaid within five years, the assets you moved into the trust will count as if they were still yours. The trust will not protect them. This is why planning ahead is so important — the cost of the trust is only useful if you create it well before you need Medicaid coverage.

Can I use the same attorney who did my will to create a Medicaid trust?

Maybe. If your attorney has experience with Medicaid planning and elder law, they can probably do it. If they specialize in general estate planning and have not worked with Medicaid trusts before, ask them to refer you to an elder law attorney. Medicaid planning is specialized enough that you want someone who does it regularly and understands the current rules in your state.