McDonald Law Firm in Columbia and Bethesda answers frequently asked questions below related to Maryland estate planning, special needs planning, Medicaid/long-term care planning and veterans pension planning. If you have other questions or require immediate assistance in one of these areas, call 443-741-1088 to schedule an initial consultation regarding your legal concerns.
Columbia and Bethesda Attorney Answers Frequently Asked Questions About Maryland Estate Planning, Special Needs Planning, and Medicaid/Long-Term Care Planning.
What is an ABLE Account and how does it work?
An ABLE account—short for an Achieving a Better Life Experience account—is a tax‑advantaged savings and investment vehicle created under federal law to help individuals with qualifying disabilities save money without losing eligibility for critical public benefits. Established by the ABLE Act of 2014, these accounts are designed to address the long‑standing challenge that individuals receiving means‑tested benefits, such as Supplemental Security Income (SSI) or Medicaid, must typically maintain very limited assets. An ABLE account allows a qualified individual, known as the designated beneficiary, to accumulate savings while preserving access to these essential programs.
To be eligible for an ABLE account, an individual must have a disability that began before age 46 (a threshold expanded in 2026 from the previous age of 26) and must either receive SSI or Social Security Disability Insurance benefits or meet a disability certification standard verified by a physician. Only one ABLE account is permitted per beneficiary, although contributions may be made by the individual, family members, or others on their behalf, subject to annual contribution limits established by law.
ABLE accounts offer significant financial advantages. Contributions grow on a tax‑deferred basis, and withdrawals are entirely tax‑free when used for qualified disability expenses. Importantly, funds held in an ABLE account generally do not count toward asset limits for most federal benefit programs, allowing individuals to save beyond traditional thresholds that might otherwise jeopardize eligibility.
Funds in an ABLE account may be used to pay for a broad range of “qualified disability expenses,” which are defined by federal law to include costs that support or improve the beneficiary’s health, independence, or quality of life. These expenses commonly include housing, education, transportation, healthcare, assistive technology, employment support, financial management services, and basic living expenses such as food and clothing. The definition is intentionally broad, allowing flexibility to meet the diverse and evolving needs of individuals with disabilities.
In practice, ABLE accounts serve as a powerful financial planning tool for individuals with disabilities and their families. By combining tax benefits with protection of public assistance, they provide a mechanism to build financial stability, fund day‑to‑day and long‑term needs, and enhance overall quality of life without sacrificing access to essential support systems.
What is a Special Needs Trust?
If you have a child with a disability, you know that child may need additional financial support throughout his or her lifetime to deal with medical issues or to supplement income due to limited employability. Government programs such as Medicaid and Supplemental Security Income (SSI) can provide monthly financial assistance, but these programs are means tested, and recipients of government assistance must keep very low income and asset limits to maintain their eligibility for benefits. A gift or inheritance therefore can wipe out a person’s ability to receive much-needed assistance.
The answer in these cases is a special needs trust. Funds can be placed into the trust and used by the beneficiary with special needs, without destroying the recipient’s income eligibility for SSI or Medicaid. Make sure your attorney is skilled and knowledgeable about special needs trusts to create a valid and enforceable trust.
What is Long-Term Care?
In layman’s terms, long-term care (LTC) is a wide range of services and support an individual may need to meet their personal care needs. For the most part, long-term care is not medical care, but rather assistance with the Activities of Daily Living (ADL) or basic personal tasks of everyday life. Long-term care encompasses ADLs such as: bathing, dressing, eating, transferring to or from a bed or chair, using the toilet, and caring for incontinence (the inability to maintain control of one’s bowel or bladder functions).
What is Medicaid?
Medicaid is a joint state and federal program that pays for long-term nursing home care and home care for people who cannot afford to pay for their own care. In Maryland, Medicaid is known as the Maryland Medical Assistance Program. In addition to paying for the cost of care for an institutionalized individual, Medicaid also protects spouses who would otherwise become impoverished because of the cost of long-term care. It does this by safeguarding a significant part of the couple’s combined income and assets. But even with these special rules for couples, known as Medicaid’s spousal impoverishment protection, the amount of assets and income a couple is allowed to keep while one of them is receiving Medicaid is limited.
Will Medicaid Pay for Assisted Living?
In Maryland, Medicaid pays for assisted living if an individual requires a higher level of care like skilled nursing care. However, a waiver is required in order to qualify for this program. The Maryland Waiver for Older Adults program permits individuals that need skilled nursing care to obtain it in their own home or at an assisted living facility. Older adults often prefer to live at home and this waiver assists them in doing so. Maryland determined that the cost of care for an older adult at home is less expensive for the state than it would be to place the individual in a nursing home. The cost of care is minimized because home care utilizes assistance from family members. Since the program is so popular in Maryland, there is currently a waiting list.
What Does Medicaid Cover?
Medicaid covers a wide range of long-term care services and support for individuals with limited income who meet specific eligibility requirements. Covered services under Medicaid include skilled nursing care in a nursing home, group home or other home and community-based settings as well as personal care services that assist people at home with activities of daily living.
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My wife and I were referred to Andre McDonald for estate planning in Washington DC. We would highly recommend him to anyone seeking help with trusts, wills, advance directives, etc. Andre patiently explains complicated law, and gives excellent advice. He is upfront regarding what he can and cannot do, what it will cost and how long it will take; no surprises.
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