NY estates planning & probate attorney Russel Morgan, Esq. explains how a revocable living trust affects a Medicaid spend-down. He points out that it does not at all. A revocable living trust is primarily used for probate avoidance, meaning it facilitates the transfer of assets from the decedent to their beneficiaries without going through probate. It serves very little, if any, purpose when it comes to a Medicaid spend-down.