Proactive planning is designed to allow people to qualify for Medicaid without losing most, if not all their resources. The main strategy is to utilize special planning techniques to make appropriate transfers at least five years before applying for institutional level of care benefits.

A ruling by the Supreme Judicial Court of Massachusetts in 2017 resulted in a big win for seniors everywhere when it comes to Medicaid estate planning and preventing assets from counting against Medicaid eligibility. The court reversed two cases — Nadeau v. Director of the Office of Medicaid, and Daley v. Secretary of the Executive Office of Health and Human Services — which pertained to eligibility for long-term assistance under the Massachusetts Medicaid program (MassHealth).

"Per stirpes," "by representation," and "per capita at each generation" are all descriptors that tell the reader how to allocate a gift among a person's descendants. They are not shorthand for contingent beneficiary provisions. (While this discussion applies to all three, I will use per stirpes for the rest of this blog.)