Raleigh Elder Law | Gifting, Taxes, and Long Term Care

One of the more common concepts that clients get confused about is taxes on gifts to children or grandchildren, and how it all works together when you're thinking about planning for Medicaid or long-term care.  This normally happens with our older clients who are getting to a point where paying for care is a concern.  The conversation normally goes something like this:

Client: "I want to give my kids $50,000.00 each.  I know I can give some amount away each year to my kids and the government won't count it, right?"

Me: "You're allowed to give $14,000 to an individual without incurring any gift tax liability."

Client: "So they can't come back and get it if I need to go into the nursing home?"

And this is where the confusion begins.  Many clients confuse the rules related to taxes on gifts with the rules related to gifts related to the Medicaid lookback, or they assume that one rule covers everything.  Unfortunately, this isn't the case.

The website "The Motley Fool" had a good, succinct article yesterday about when a person should consider making gifts to heirs.  The article, which can be found here, has as straightforward an explanation of gifts and taxes as I've seen.  It also raises a good point, namely, have you considered how you are going to pay for long-term care after you've made these gifts?

The important points to remember are:

1. Gifts made for tax purposes are not always protected from the Medicaid lookback rules, if such gifts are made within five years of applying for Medicaid assistance.  This five year period is also called the "lookback" period, and it is what it says.  Social Services is looking back through your financial history to determine whether you have made gifts of assets that should have instead been used to pay for your long-term care.  There are certain situations in which you may be able to overcome this presumption, but the safe rule of thumb is that Social Services will count those gifts against you.
2. If you have your cost of care covered, either with long-term care insurance, or with other assets, remember to take into consideration the assets you are gifting.  Gifts of stocks or real property can result in adverse tax consequences down the road for the recipient.  Why?  Because generally speaking, gifts during the life of the donor (donor is the person making the gift) retain the basis of the donor in the hands of the donee (the person receiving the gift).  In English?  OK, OK.  Let's say I bought 5,000 shares of stock in ABC Corporation for $1.00 each 20 years ago.  My basis in these shares is $5,000.00.  If today they are worth $10.00 per share, and I sold them, I would have a taxable gain of $45,000.00.  

If I give the shares away to my sister when they are worth $10.00 per share, my sister's basis would not be $50,000.00, it would be what I paid for them: $5,000.00, meaning that if my sister were to sell the shares, she would be taxed on the $45,000.00. 

If I retained my shares, and gave them to my sister via my Will when I died, she would receive the shares with the basis "stepped up" to the value of the shares the day I died.  So if when I died, the shares were worth $100 per share, my sister's basis would be $100 per share.  If she sold the stock that same day, she would owe no taxes on the money received from the sale.

So what does this mean?  If you're going to make gifts, think about the type of asset you're giving.  If it's something you didn't pay much for but is worth an awful lot now, consider holding onto that asset and passing it at death.  

Where does this tie in with the Medicaid lookback rules?  If you're worried about protecting assets for long-term care and/or Medicaid eligibility, but want to make sure that your beneficiaries retain the advantages of a stepped-up basis in the asset, consider estate planning that will do both.  There are several different ways to ensure that assets will not be subject to estate recovery should you need Medicaid assistance, while retaining the step-up in basis provided by an on-death transfer.  Irrevocable trusts and gift deeds reserving life estate are one common way of doing this, but it needs to be done properly, and it needs to be part of an overall plan that will leave you with the assets you need and access you need to be able to live comfortably during retirement.

If you have questions about these issues, or need advice about planning for long-term care, talk to an attorney (like me!) who deals specifically with these matters.