Planning for long-term care can be overwhelming, especially when it comes to understanding Medicaid eligibility in New York. Many families only start thinking about Medicaid Planning when a loved one needs immediate care, but qualifying for benefits requires careful planning. Without the right strategy, you could face financial hardships, delays, or even denials when you need help the most.
Medicaid planning describes the service experienced financial and estate professionals provide to those seeking to become eligible for Medicaid. Medicaid planning involves employing financial and legal strategies to protect your assets while ensuring that you qualify for Medicaid benefits when you need them to pay for long-term care expenses.
Long-term care includes a variety of services needed by those who can't do everyday activities because of health problems or disabilities. Long-term care helps with daily tasks like bathing, eating, and moving around. It's provided through nursing homes, assisted living and home health aides.
The cost of long-term care in New York can be huge. For instance, according to "Genworth’s Cost of Care Calculator," the median cost of staying in a semi-private nursing home in the Rockford area can cost over $171,000 a year! That's a lot of money and can use up your savings quickly. To handle these costs, people may consider using their money to buy insurance, Medicare, or Medicaid. However, Medicaid is special because it's meant to help people who don't have a lot of money or assets, and Medicare does not pay for long-term care expenses.
Medicaid, a joint New York state and federal program, provides health coverage to low-income individuals of all ages. In some places, it might even pay for your stay in a nursing home for as long as you need it. To become eligible for Medicaid, you need to prove you don't have more than a certain amount of assets and income, which varies by state and the type of Medicaid coverage sought.
New York’s Medicaid program provides essential health coverage for low-income individuals, including coverage for long-term care in nursing homes and at home. However, the program has strict income and asset limits that determine eligibility.
For 2024, Medicaid eligibility in New York is based on specific financial criteria:
While these numbers seem straightforward, eligibility rules are complex. Some assets, such as a primary residence (if the applicant intends to return home or if a spouse lives there), are exempt from Medicaid’s calculations. Additionally, excess income can sometimes be redirected into a Medicaid-compliant trust to help an applicant qualify.
Medicaid planning describes the service experienced financial and estate professionals provide to those seeking to become eligible for Medicaid. It is a federal and state program designed to assist with healthcare costs and long-term care for those who could not otherwise afford it. Medicaid planning involves employing financial and legal strategies to protect your assets while ensuring that you qualify for Medicaid benefits if and when you need them.
One of the biggest mistakes families make when planning for Medicaid is improperly transferring assets. New York enforces a look-back period to prevent applicants from giving away assets simply to meet Medicaid’s financial limits.
If Medicaid finds that assets were gifted or transferred for less than fair market value during this time, it can impose a penalty period, delaying coverage for months or even years.
The good news is that there are legal strategies to protect your savings while ensuring you qualify for Medicaid when you need it. Working with an experienced Medicaid planning attorney can help you navigate these options:
A Medicaid Asset Protection Trust (MAPT) allows you to transfer assets into an irrevocable trust while still being able to benefit from them indirectly. Because the assets are no longer in your name, they are not counted for Medicaid eligibility. However, MAPTs must be set up at least five years before applying for nursing home Medicaid to avoid penalties under the look-back period.
If only one spouse needs Medicaid, the healthy spouse (community spouse) can keep a portion of the couple’s assets. In 2024, the maximum CSRA in New York is $154,140, allowing the community spouse to retain a significant amount of assets without affecting the Medicaid applicant’s eligibility.
A Medicaid-compliant annuity converts excess assets into an income stream, which can help applicants meet asset limits while preserving wealth for their spouse. These annuities must be structured correctly to comply with Medicaid rules.
If you own a home, you may be able to transfer it while retaining a life estate, which allows you to live in the home while ensuring it passes to your heirs without Medicaid penalties.
For individuals whose income exceeds Medicaid’s limit, a pooled income trust can be used to deposit excess income while still allowing access to funds for personal expenses. This is a valuable tool for those seeking Community Medicaid services.
Many families wait until a crisis occurs before considering Medicaid planning, but by then, options are limited. The best time to start planning is well before care is needed. Early planning ensures you have access to the best strategies to protect your assets and qualify for benefits without unnecessary stress.
Navigating Medicaid eligibility in New York can be challenging, but you don’t have to do it alone. An experienced New City Medicaid planning attorney can help you develop a strategy tailored to your needs, ensuring you or your loved ones receive the care they deserve without losing hard-earned assets. Book a call with Parker Law Firm with offices in New City and White Plains to discuss your New York Medicaid planning options today.
Reference: SmartAsset (Feb 16, 2023) “3 Ways to Protect Assets from Medicaid”
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