4 RETIREMENT ACCOUNTS MEDICAID COUNTS AGAINST YOU — AND THE ANNUITY LOOPHOLE THAT HIDES THEM

The financial industry spent fifty years telling you to max out your 401(k) and roll it into an IRA — and almost nobody told you that the same account is treated by Medicaid as fully countable cash in roughly half the states in the country, forcing you to spend it down to $2,000 before Medicaid pays a single dollar toward your nursing home care. Traditional IRAs, Roth IRAs, pensions, and employer-sponsored 403(b) and 457(b) accounts are each treated differently — sometimes wildly differently — depending on which state you live in and whether the account is in payout status. This bulletin breaks down all four account types and the Medicaid-compliant annuity conversion strategy that can legally protect a meaningful share of a countable IRA before a health crisis forces an unplanned spend-down. Chapter Timestamps: 00:00 — Walter's Story: The IRA Built Exactly the Way He Was Told To Build It 03:50 — The Dirty Math: Payout Status, the Income Cap, and the State-by-State Lottery 09:45 — Who Built This Trap: Medicaid 1965 vs. the 401(k) Era 13:00 — Account #1 and #2: Traditional IRA and Roth IRA 16:45 — Account #3 and #4: Pensions, the Miller Trust, and Employer Plans 20:00 — The Loophole: The Medicaid-Compliant Annuity Conversion 22:45 — Walter's Decision and the Closing Window Disclaimer: This video is for educational and informational purposes only and does not constitute legal, financial, tax, or Medicaid planning advice. Medicaid resource counting rules, payout status exemptions, income cap thresholds, and Medicaid-compliant annuity requirements vary significantly by state and are subject to change. Medicaid-compliant annuity structures require precise compliance with federal actuarial soundness and beneficiary designation requirements; improperly structured annuities can trigger disqualifying transfer penalties. Consult a Certified Elder Law Attorney (CELA) and a financial professional experienced in Medicaid-compliant annuity products before converting, restructuring, or annuitizing any retirement account. Authoritative Sources: Social Security Administration POMS SI 01120.200 — Retirement Funds (Resource Treatment): https://secure.ssa.gov/poms.nsf/lnx/0... 42 USC §1396p — Medicaid Liens, Adjustments, Recoveries, Transfers of Assets, and Annuity Rules (Cornell LII): https://www.law.cornell.edu/uscode/te... National Elder Law Foundation — Find a CELA Attorney by State: https://www.nelf.org/find-a-cela #MedicaidPlanning #IRAProtection #401kRetirement #MedicaidCompliantAnnuity #ElderLaw #RetirementAccounts #MillerTrust #MedicaidEligibility #LongTermCarePlanning #RothIRA