Schedule ConsultationEstate Planning Basics for Massachusetts Seniors: A Practical Checklist
By North Shore Elder Law & Estate Planning Editorial Team · Updated August 14, 2026
For most Massachusetts seniors, the foundation of an estate plan includes a durable power of attorney, health care proxy, HIPAA authorization, and will. Depending on the person’s assets, family circumstances, long-term-care concerns, and goals, a trust may also be appropriate. A complete plan should coordinate these documents with beneficiary designations, account ownership, real estate, and any MassHealth or estate-tax planning that may be needed.
Key Takeaways
- A will is only one part of an estate plan. Planning for incapacity is equally important.
- A durable power of attorney can authorize someone to handle financial and legal matters if assistance becomes necessary.
- A Massachusetts health care proxy appoints an agent to make health-care decisions when the proxy becomes operative.
- A will generally controls probate assets, while jointly owned property, trust assets, and accounts with valid beneficiary designations may pass outside the will.
- Massachusetts has its own estate tax rules, including a $2 million applicable exclusion amount for estates of people dying in 2023 or later.
- Certain MassHealth long-term-care benefits are subject to transfer rules that can include a 60-month look-back period.
- Trusts serve different purposes. A revocable trust can help with management and probate avoidance for properly funded assets, but it generally does not shield the person who created it from creditors.
What Estate Planning Documents Do Massachusetts Seniors Need?
There is no single set of documents required for every senior. However, several documents commonly form the foundation of a Massachusetts estate plan.
Durable Power of Attorney
A durable power of attorney authorizes an agent to handle specified financial and legal matters on behalf of the person creating the document.
Under Massachusetts law, a durable power of attorney can be drafted so that authority continues despite the principal’s later disability or incapacity. It may also be drafted to become effective upon disability or incapacity. The specific powers granted depend on the language of the document.
Massachusetts General Laws Chapter 190B, Section 5-501 explains the requirements for a durable power of attorney.
A durable power of attorney can be particularly important because the absence of appropriate financial authority may increase the possibility that a court proceeding for a conservator will be needed if a person later becomes unable to manage financial affairs.
Learn more about estate planning in Massachusetts.
Health Care Proxy
A Massachusetts health care proxy allows a competent adult to appoint a health care agent to make health-care decisions if the person later lacks the capacity to make those decisions.
The agent does not automatically take over medical decision-making simply because the document has been signed. The proxy becomes operative after the required determination of incapacity under Massachusetts law. The principal can also place limitations on the agent’s authority.
Massachusetts General Laws Chapter 201D governs health care proxies.
Mass.gov also provides information about Massachusetts health care proxies and living wills.
HIPAA Authorization
A HIPAA authorization can give designated people permission to obtain or discuss protected health information.
This document can be useful even when a health care proxy is already in place. A person who is legally authorized to make health-care decisions may qualify as a personal representative under federal HIPAA rules for information related to that authority, but a separate HIPAA authorization can permit additional people to receive information or provide access before someone is acting as the patient’s health-care decision-maker.
The U.S. Department of Health and Human Services explains the HIPAA rules for personal representatives.
Will
A will directs the disposition of property that passes through the probate estate and can nominate the person who will administer the estate.
A will does not necessarily control every asset a person owns. Property may pass outside the will through:
- Joint ownership with survivorship rights
- Beneficiary designations
- Transfer-on-death arrangements where applicable
- Trust ownership
- Other nonprobate transfer mechanisms
This distinction is important. A person can have a carefully drafted will and still have assets pass differently because of account ownership or beneficiary designations.
Mass.gov provides additional information about Massachusetts wills and estates.
Revocable and Irrevocable Trusts
Trusts can serve several different estate-planning purposes, including managing assets, providing for beneficiaries, coordinating distributions, and allowing properly funded trust assets to pass outside probate.
A revocable trust should not be confused with an asset-protection trust. Under Massachusetts law, property in a revocable trust remains subject to claims of the settlor’s creditors during the settlor’s lifetime.
Massachusetts General Laws Chapter 203E, Section 505 addresses creditor claims against a settlor.
An irrevocable trust can operate very differently, but simply labeling a trust “irrevocable” does not automatically create creditor protection or MassHealth eligibility. The trust terms, assets transferred, retained rights, timing, and applicable law all matter.
For a more detailed discussion of wills, trusts, health care proxies, and MassHealth, see Massachusetts Estate Planning for Seniors: A 2026 Guide.
What Is Different About Estate Planning for Seniors in Massachusetts?
National estate-planning advice often provides a useful starting point, but Massachusetts seniors face several state-specific issues that can materially affect a plan.
Massachusetts Has Its Own Estate Tax
Massachusetts imposes a separate state estate tax. For estates of people dying in 2023 or later, Massachusetts uses a $2 million applicable exclusion amount. Changes to the federal estate-tax exemption do not change that Massachusetts threshold.
Massachusetts Department of Revenue guidance is available in the Massachusetts Estate Tax Guide.
The difference between Massachusetts and federal law can be substantial. For 2026, the federal basic exclusion amount is $15 million.
The IRS provides additional information about the federal estate tax.
As a result, an estate may be well below the federal estate-tax threshold but still require Massachusetts estate-tax planning.
Massachusetts Uses the Health Care Proxy Under Chapter 201D
Massachusetts General Laws Chapter 201D provides the statutory framework for appointing a health care agent.
Massachusetts does not have a statute giving a living will the same statutory role as a Chapter 201D health care proxy. A living will or personal directive can still provide useful evidence and guidance about treatment preferences, but the health care proxy is the Massachusetts statutory instrument used to appoint the person authorized to make health-care decisions when the principal lacks capacity.
See Mass.gov’s guidance on health care proxies and living wills.
MassHealth Planning Can Affect Long-Term-Care Decisions
Massachusetts administers Medicaid through MassHealth.
For certain MassHealth long-term-care benefits, transfers of assets for less than fair market value may be reviewed under a 60-month look-back period and can result in a period of ineligibility. The rules also contain important exceptions, so a transfer during the look-back period does not automatically have the same effect in every situation.
MassHealth provides guidance concerning look-back periods for certain asset transfers.
This is one reason seniors concerned about future nursing-home costs should consider long-term-care planning before transferring a home, placing assets into a trust, or making substantial gifts.
Learn more about MassHealth planning and eligibility.
Does a Will Avoid Probate in Massachusetts?
No. A will does not avoid probate.
A will provides instructions for assets that pass through the probate estate. Probate is the court-supervised process used to administer certain property after death. Massachusetts recognizes several probate procedures depending on the circumstances.
Mass.gov provides an overview of the probate of wills and estates in Massachusetts.
Assets that pass by beneficiary designation, survivorship ownership, or a properly funded trust may avoid probate even though other assets in the same estate require probate.
This is why estate planning should address more than the will itself.
Does Creating a Trust Automatically Avoid Probate?
No.
A trust can help avoid probate only for property that is actually governed by the trust. Signing a trust agreement without transferring appropriate assets into the trust may leave those assets outside the trust and potentially subject to probate.
Trust funding may involve changing account ownership, preparing deeds, or coordinating other ownership arrangements. Not every asset should necessarily be retitled into a trust, so funding decisions should match the purpose and terms of the estate plan.
What Should Seniors Review After Signing Estate Planning Documents?
Estate planning is not complete merely because documents have been signed.
A practical implementation review should consider:
- Whether beneficiary designations match the overall estate plan
- Whether jointly owned accounts and real estate will pass as intended
- Whether assets intended for a trust have actually been transferred to it
- Whether deeds need to be changed
- Whether retirement accounts and life insurance beneficiaries are current
- Whether the people named as agents, personal representatives, or trustees are still appropriate
- Whether important documents can be located when they are needed
- Whether changes in family circumstances, assets, health, or tax law require updates
The goal is coordination. A will, trust, beneficiary designation, and ownership arrangement can each control different property, so inconsistent instructions can produce results the person did not intend.
What Happens If Incapacity Planning Is Missing?
The absence of a durable power of attorney or operative health care proxy does not automatically mean that a court proceeding will be required. However, in some circumstances, a family may need to seek a guardianship, conservatorship, or other court authority if a person becomes incapacitated without an effective alternative already in place.
Massachusetts recognizes less restrictive alternatives to guardianship and conservatorship, including health care proxies, powers of attorney, and certain trusts.
Mass.gov provides information about alternatives to guardianship and conservatorship.
North Shore Elder Law & Estate Planning provides additional information about guardianships and conservatorships in Massachusetts.
Massachusetts Senior Estate Planning Checklist
A Massachusetts senior reviewing an existing estate plan can start with these questions:
- Do I have a current durable power of attorney?
- Have I named the right person to make health-care decisions if I lose capacity?
- Do I have a HIPAA authorization that allows the appropriate people to obtain medical information?
- Does my will still reflect my wishes?
- Have my beneficiary designations been reviewed recently?
- Do my account titles and real-estate ownership match the plan?
- If I have a trust, has it been properly funded?
- Do I understand whether my estate could be affected by the Massachusetts estate tax?
- If long-term-care costs are a concern, have I considered whether MassHealth planning is relevant?
- Do the people I have appointed know where the important documents are located?
A “yes” to having estate-planning documents is only the beginning. The more important question is whether the documents and ownership arrangements still work together.
Frequently Asked Questions
What are the basic estate planning documents for a Massachusetts senior?
Commonly recommended documents include a durable power of attorney, health care proxy, HIPAA authorization, and will. A revocable or irrevocable trust may also be appropriate depending on the person’s assets, family situation, tax exposure, long-term-care concerns, and planning goals.
Is a living will legally binding in Massachusetts?
Massachusetts does not have a statute giving living wills the same statutory status as a health care proxy. A living will or personal directive can still communicate treatment preferences and provide guidance. A Massachusetts health care proxy under Chapter 201D is the statutory document used to appoint a health care agent.
Does a will keep an estate out of probate?
No. A will governs property passing through the probate estate. Assets passing through beneficiary designations, survivorship ownership, trusts, or other nonprobate arrangements may pass outside probate.
Does a revocable trust protect assets from creditors?
Generally, no. Massachusetts law provides that property in a revocable trust remains subject to claims of the settlor’s creditors during the settlor’s lifetime. Different rules may apply to properly structured irrevocable trusts depending on their terms and circumstances.
Does MassHealth have a five-year look-back period?
For certain MassHealth long-term-care benefits, MassHealth can review transfers made during a 60-month look-back period. Transfers for less than fair market value can affect eligibility, but exceptions and special rules apply. The effect of a particular transfer depends on the circumstances.
Is It Time to Review Your Estate Plan?
If you already have a will or trust but are unsure whether your documents, beneficiaries, account ownership, and long-term-care planning still work together, an estate-plan review can identify gaps before they become more difficult to address.
North Shore Elder Law & Estate Planning in Melrose helps seniors and families throughout the North Shore and Massachusetts with estate planning, elder law, and MassHealth planning.
To discuss creating or reviewing an estate plan, contact North Shore Elder Law & Estate Planning.
