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Some cases stand for the black-letter rule or law determined by the court. Some cases serve as object lessons regarding the costs, uncertainties, and inherent risks of litigation. The recent case of In re Estate of Sizick (Mich. Mar. 18, 2026), serves as both: the decision is favorable to seniors and their families, but the case, nonetheless, serves as an object lesson regarding the cost NS complexities of Medicaid, and why proactive aging-in-place planning and Medicaid asset protection planning are superior alternatives.
In a unanimous decision, the Michigan Supreme Court ruled that probate courts can consider the future availability of Medicaid benefits when deciding whether to issue a protective order transferring assets and income to a community spouse. The Court overruled prior precedent that had limited this forward-looking approach, giving married couples facing nursing home care more tools to protect the healthy spouse from impoverishment.
While this is a positive development for Michigan families already in crisis, the case itself reveals a much more profound lesson: the Sizick family endured years of expensive, stressful, and complicated litigation, including multiple trips to the Court of Appeals and ultimately the Michigan Supreme Court, to achieve what proper advanced planning could have accomplished with greater certainty and ease, and far less expense.
The holding in this case does not apply to our clients in Ohio or Missouri. Neither Ohio nor Missouri offers the same type of broad pre-eligibility probate court protective order that Michigan now allows after In re Estate of Sizick (where the court can proactively transfer most or all assets to the community spouse while considering future Medicaid eligibility).
Ohio
Both Missouri and Ohio rely primarily on the standard CSRA calculation and administrative processes rather than on expansive court-protective orders. This makes advanced planning (Medicaid Asset Protection Trusts established 5+ years in advance, proper titling of assets, spousal annuities, etc.) even more important and valuable in Ohio and Missouri to protect assets beyond what the standard CSRA allows. The High Cost of Waiting
By the time Jerome Sizick entered a nursing home, the family had to petition the probate court for a protective order, fight DHHS objections, and navigate a lengthy appeals process. What should have been a straightforward asset-protection step accomplished years before, turned into a multi-year legal battle with significant attorney fees, court costs, and emotional strain.
This complicated procedural posture highlights a reality we see often in elder law: reacting to a crisis almost always costs more in money, time, and peace of mind than planning and preparing in advance.A Better Path: Balanced Aging-in-Place and Medicaid Asset Protection Planning
With proper planning while both spouses were still healthy and had capacity, the Sizicks could likely have:
Court victories like Sizick are helpful, at least in this case for Michiganders, but they are not a substitute for robust proactive planning. The best time to protect your home, savings, and spouse’s security is now — while you still have full control and before a health event forces you into reactive, high-cost legal proceedings.
If you or a loved one is concerned about future long-term care costs, we strongly encourage you to meet with an experienced elder law attorney to explore a customized aging-in-place plan combined with effective Medicaid protection strategies.
Don’t wait until a crisis forces you into years of litigation. Proactive planning remains the most powerful and cost-effective way to protect your family’s future.
While this is a positive development for Michigan families already in crisis, the case itself reveals a much more profound lesson: the Sizick family endured years of expensive, stressful, and complicated litigation, including multiple trips to the Court of Appeals and ultimately the Michigan Supreme Court, to achieve what proper advanced planning could have accomplished with greater certainty and ease, and far less expense.
The holding in this case does not apply to our clients in Ohio or Missouri. Neither Ohio nor Missouri offers the same type of broad pre-eligibility probate court protective order that Michigan now allows after In re Estate of Sizick (where the court can proactively transfer most or all assets to the community spouse while considering future Medicaid eligibility).
Ohio
- Ohio follows the standard Community Spouse Resource Allowance (CSRA) rules: generally 50% of countable assets up to the federal maximum (~$162,660 in 2026), with a minimum floor.
- Ohio does allow Spousal Refusal (“Just Say No”) in certain situations, where the community spouse refuses to use their assets for the institutionalized spouse’s care. This can help protect more assets but comes with risks (potential future recovery claims by the state).
- Community spouses can request a fair hearing or, in some cases, a court order for additional support, but Ohio does not have the same proactive, forward-looking protective order authority as Michigan’s probate courts post-Sizick.
Missouri
- Missouri also uses the standard federal Division of Assets process (sometimes called “spousal share”).
- The community spouse generally receives 50% of the couple’s countable assets, subject to the current minimum (~$32,500) and maximum CSRA (~$162,660 in 2026).
- This is handled administratively through the Missouri Medicaid agency (MO HealthNet) during the eligibility process.
- While a court order can sometimes increase the income allowance (MMMNA), Missouri does not have a robust mechanism for a probate court to issue a broad protective order transferring excess assets before Medicaid applies, as Michigan now permits.
Both Missouri and Ohio rely primarily on the standard CSRA calculation and administrative processes rather than on expansive court-protective orders. This makes advanced planning (Medicaid Asset Protection Trusts established 5+ years in advance, proper titling of assets, spousal annuities, etc.) even more important and valuable in Ohio and Missouri to protect assets beyond what the standard CSRA allows. The High Cost of Waiting
By the time Jerome Sizick entered a nursing home, the family had to petition the probate court for a protective order, fight DHHS objections, and navigate a lengthy appeals process. What should have been a straightforward asset-protection step accomplished years before, turned into a multi-year legal battle with significant attorney fees, court costs, and emotional strain.
This complicated procedural posture highlights a reality we see often in elder law: reacting to a crisis almost always costs more in money, time, and peace of mind than planning and preparing in advance.A Better Path: Balanced Aging-in-Place and Medicaid Asset Protection Planning
With proper planning while both spouses were still healthy and had capacity, the Sizicks could likely have:
- Deployed a well-drafted Medicaid Asset Protection Trust (MAPT) to shelter assets from future long-term care costs while preserving eligibility for the community spouse.
- Built a strong Aging-in-Place Plan (financial and legal planning to enable home modifications, in-home care coordination, family caregiver agreements, and long-term care insurance review) to delay or avoid institutionalization altogether.
- Included clear, comprehensive powers of attorney and healthcare directives to reduce the need for court intervention.
Court victories like Sizick are helpful, at least in this case for Michiganders, but they are not a substitute for robust proactive planning. The best time to protect your home, savings, and spouse’s security is now — while you still have full control and before a health event forces you into reactive, high-cost legal proceedings.
If you or a loved one is concerned about future long-term care costs, we strongly encourage you to meet with an experienced elder law attorney to explore a customized aging-in-place plan combined with effective Medicaid protection strategies.
Don’t wait until a crisis forces you into years of litigation. Proactive planning remains the most powerful and cost-effective way to protect your family’s future.
