Michigan Supreme Court Ruling: A Win for Families But a Cautionary Tale Favoring Proactive Planning

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

• 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.

Bottom Line for Planning

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.

A balanced approach established five years before need would have given the family far greater control, privacy, and predictability, without the need for expensive probate court battles after a health crisis.The Takeaway for Our Readers
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.

 

A Collaborative Approach to Long-Term Care Planning: Why Aging Life Care Managers, Elder Law Attorneys, and Financial Planners Belong on the Same Team

Long-term care planning is rarely a simple checklist. It involves evolving health needs, family dynamics, legal protections, and financial realities that change over time. A new article in the Wealth Strategies Journal highlights a powerful truth: the most successful outcomes for older adults occur when Aging Life Care Managers® (ALCMs), elder law attorneys, and financial planners work together as an integrated team. This collaborative model aligns perfectly with our core philosophy— helping families age in place with dignity, security, and as much independence as possible.

Aging Life Care Managers®Also known as geriatric care managers, certified Aging Life Care Managers® are specially trained professionals who take a holistic, on-the-ground look at an older adult’s situation. Unlike doctors who primarily focus on medical diagnoses and hospital charts, these managers assess the full picture: the person’s physical and cognitive abilities, daily living skills, family dynamics, home environment, and available community resources. Their goal is practical: to help seniors remain safely at home as long as possible while reducing stress on family caregivers.  They bring insights that families often cannot reach on their own, including:

• Up-to-date local costs for home care agencies, adult day programs, assisted living, and other services in the specific geographic area.  

• Realistic projections of how care needs are likely to progress over the next 6–24 months based on the individual’s diagnoses and current functional status. 

• Early warning signs of caregiver burnout, isolation, or even financial exploitation that families may overlook when they are deep in the day-to-day duties of caregiving.  

• Practical guidance on transitions that always prioritizes the older adult’s stated wishes and values.

The following are real-world examples of the insights they offer:

• Identifying that a senior is at high risk of dangerous medication errors (especially with blood thinners such as Warfarin or Eliquis). An Aging Life Care Manager might recommend a locked, timed medication-dispensing machine (sometimes called a “medicine vending machine”) that only releases the correct dose at the right time. This simple technology can dramatically reduce the risk of over- or under-dosing,  a common reason seniors are institutionalized.  

• Spotting that the bathroom is the real safety hazard and arranging for a zero-threshold walk-in shower, grab bars, and a raised toilet seat before a fall occurs.  

• Compassionately noticing that the primary family caregiver is nearing burnout and assisting in respite care or adult day services, and/or resilience training so the senior can stay at home instead of being moved to a facility.  

• Discovering that a “helpful” neighbor or distant relative has begun influencing financial decisions and recommending safeguards such as a monitored bank account or a professional power of attorney review.

In short, Aging Life Care Managers serve as the practical, local experts who translate medical information into workable, day-to-day solutions that keep older adults safer, more independent, and living at home longer.Collaboration BenefitsWhen Aging Life Care Managers (ALCMs), elder law attorneys, and financial planners work together as a coordinated team, each professional receives far more specific, real-world information than they could gather on their own. Instead of relying on incomplete medical records, generic cost averages, or a family’s best guesses, the team gains a shared, accurate picture of the older adult’s functional abilities, cognitive status, safety risks, and daily living realities. This shared intelligence allows every recommendation,  legal, financial, or care-related,  to be grounded in what is actually happening in the home, rather than in theory.        For Elder Law Attorneys:ALCMs supply critical functional and cognitive assessments that inform the timing and content of powers of attorney, guardianship decisions, Medicaid planning, and capacity-sensitive documents such as Supported Decision-making (SDM)  advance directives or agreements.  This helps create legal strategies that are not only technically sound but also realistic for the client’s actual daily life.  For example, if the care manager observes that a senior is consistently refusing necessary medical care (refusing to go to the doctor or hospital), the attorney can evaluate whether limited guardianship of the person may be needed to protect health and safety. If the ALCM recommends a family-team approach to caregiving, the attorney can draft a formal family caregiver agreement that clarifies roles, compensation, and expectations, reducing future conflict.         For Financial Planners:Care managers translate health trends into accurate, evolving cost projections. Instead of generic averages, planners receive scenario-based forecasts that account for different aging-in-place pathways, potential transitions, and changing needs. This makes retirement and long-term care projections far more resilient. An ALCM might flag the need for future home modifications (zero-step entry, wider doorways, accessible bathroom) or a wheelchair-accessible vehicle. With that information, the planner can help the family reallocate resources, explore reverse-mortgage options, or free up income streams specifically earmarked for those independence-preserving improvements. The result is a financial plan that anticipates real care costs rather than reacting to them after a crisis.        For Families:A coordinated team reduces crises, minimizes last-minute expensive decisions, improves communication, and lowers stress. Clients benefit from plans that align care preferences, legal protections, and financial resources, all working toward the goal of staying at home safely and comfortably for as long as possible.  When the ALCM identifies early signs of caregiver burnout, the team can introduce caregiving resilience training or arrange respite services before the primary caregiver collapses. When passive fall-detection systems or medication-dispensing technology are recommended, the attorney and planner can help implement them quickly and sustainably. The family no longer has to piece together advice from disconnected professionals; instead, they receive a unified roadmap.  In short, collaboration turns three separate experts into one integrated support system. Each professional works with better information, families face fewer surprises, and the older adult has a stronger chance of aging in place with dignity and safety.Collaboration Supports Aging in Place

One of the strongest advantages of this interdisciplinary approach is its focus on practical home-based solutions. Rather than defaulting to institutional care when costs or complexity rise, the team can:

• Design sustainable in-home care budgets;
• Coordinate services that maximize independence;
• Build contingency plans before a crisis forces a move or threatens family independence; and
• Help families navigate long-term care insurance claims or Medicaid eligibility while protecting assets.

The Takeaway for Families

If you’re helping a parent or loved one plan for the future, don’t tackle legal, financial, and care decisions in isolation. Seek professionals who are willing to collaborate. The right elder law attorney, financial advisor, and Aging Life Care Manager working together can create a comprehensive, adaptable plan that truly supports your family’s goals.  At our practice, we regularly partner with trusted care managers and financial professionals precisely because this team approach delivers better, more compassionate, less expensive, and safer (less risky)  results.  Planning proactively with the right team is one of the most effective ways to protect both dignity and dollars while aging in place.