Medicaid eligibility in New York stands out as a common source of anxiety and confusion for many individuals. Our experienced attorneys are dedicated to making the process easier for our clients. The answers to the frequently asked questions on this page aim to provide general insights into some of the complex issues surrounding Medicaid planning.
For specific answers to your family’s pressing questions about Medicaid planning, call Amoruso & Amoruso LLP today or contact us online for a consultation with our New York elder law and estate planning attorneys.
What Is Medicaid Planning?
Medicaid is a joint federal and state program run by the states that helps pay for medical care and long-term care for individuals with limited income and resources. It provides a valuable lifeline for Americans who need assistance in their golden years, especially as the cost of nursing and elder care continues to rise.
Medicaid is needs-based, and individuals with income and assets above a certain threshold are ineligible – even if those assets are insufficient to pay for necessary care without assistance.
Medicaid planning in New York involves strategically organizing your finances and assets to qualify for NYS Medicaid while preserving as much of your wealth as possible. The process ensures you can receive necessary long-term care without depleting your resources.
Effective Medicaid planning often includes:
- Asset-protection strategies
- Creation of trusts
- Careful gifting
- Spend-down techniques
Our skilled elder law attorneys can guide you through these complex processes, helping you understand the Medicaid eligibility requirements in NY and safeguarding your family’s financial future.
Who Needs Medicaid Planning?
Medicaid planning can benefit many individuals, particularly:
- Seniors anticipating the need for long-term care and nursing home costs
- People with chronic illnesses or disabilities in need of personal care services
- Individuals who need elder care but want to preserve assets for their heirs
Even if you currently have substantial assets, unforeseen health issues can quickly diminish your savings. Proactive Medicaid planning helps protect your hard-earned wealth and access to medical care when you need it most.
What Are My Options for Medicaid Planning?
NYS Medicaid consists of two different options: Institutional/Nursing Home Medicaid and Community/Home Care Medicaid. You must meet different eligibility requirements depending on the type of care you need or wish to receive.
Institutional/Nursing Home Medicaid applies to individuals who expect to need a nursing home level of care as they age. It covers the cost of long-term care for services like medical care, daily activities such as toileting, bathing, and dressing, mental health treatment, and providing access to social activities.
By contrast, Community/Home Care Medicaid is for those who do not require a nursing home level of care but do need assistance with their activities of daily living (ADL’s), such as eating, dressing, bathing, transferring, and toileting, and wish to receive care at home, at a family caregiver’s home, or in a long-term adult care facility. Services may come through the Managed Care/Long-Term Care Program (MCTLC) or the Assisted Living Program (ALP), depending on the individual’s preferences and needs.
All programs have various asset and income thresholds. Medicaid planning can help individuals meet these requirements to avoid undue financial hardships or penalties.
When Should I Start Medicaid Planning?
The best time to start Medicaid planning is now. Many people mistakenly believe they should wait until they are close to needing long-term care to begin planning. However, early planning offers several advantages, including:
- More options for asset protection
- Reduced stress during health crises
- Better chance of qualifying for Medicaid when needed
- Preservation of more assets for survivors
What Is the Lookback Period for Medicaid?
New York aims to prevent people from giving away assets solely to qualify for Nursing Home Medicaid through a five (5) year lookback requirement. When a person applies for Nursing Home Medicaid, the NYS Dept. of Social Services examines all financial transactions an applicant made during the five (5) years before applying for benefits. The agency scrutinizes any asset transfers, sales of property below fair market value, or creation of trusts by the Medicaid applicant during the lookback window. If Medicaid finds improper transfers during this time, they may impose a penalty period of ineligibility. They might also require repayment of transferred assets.
New York Community/Home Care Medicaid rules are different. Currently, there is no lookback period for Community Medicaid. However, New York is considering a change that would impose a 30-month lookback period for home care Medicaid applicants. Amoruso & Amoruso LLP is monitoring the status of the proposed rule change and can advise clients on how that may impact their Medicaid planning timeline.
What Assets Are Considered in Medicaid Eligibility?
When determining Medicaid eligibility in NY, the state examines various assets, including:
- Bank accounts
- Stocks and bonds
- Real estate (excluding your primary residence in some cases)
- Vehicles (beyond one car)
- Life insurance policies with cash value
- Retirement accounts
It is worth noting that Medicaid views your assets differently from how you might. For example, it may count jointly held assets or certain trusts you have created as yours alone. Working with our experienced Medicaid planning attorneys can help you understand how Medicaid will view your specific financial situation and develop strategies to protect your assets while maintaining eligibility for benefits.
Can I Give Away My Assets to Qualify for Medicaid?
While you can give away assets to meet the threshold, doing so without proper planning could jeopardize your Medicaid eligibility. Many people assume they can simply transfer their assets to family members to qualify for Medicaid. However, the New York Medicaid program penalizes certain asset transfers, and giving gifts for this purpose can lead to a period of ineligibility.
Instead of giving away assets haphazardly, consider these strategies:
- Creating irrevocable trusts such as a Medicaid asset protection trust
- Making allowable transfers to certain family members
- Spending down assets on exempt items
Our knowledgeable elder law attorneys can help you develop a comprehensive plan that protects your assets while maintaining Medicaid eligibility.
Are There Any Assets That Are Exempt from Medicaid Eligibility?
Some assets are exempt from Medicaid eligibility calculations. These exemptions allow you to maintain certain resources without affecting your eligibility. Common exempt assets include:
- Your primary residence (up to a certain equity value)
- One vehicle
- Personal belongings and household items
- Burial plots and prepaid funeral arrangements
- Life insurance policies with limited cash value
- Some retirement accounts, depending on how they’re structured
Additionally, if you are married and your spouse is not applying for Medicaid, they may keep:
- A portion of your joint assets as a Community Spouse Resource Allowance (CSRA), which lets a non-applicant spouse keep a portion of a couple’s assets without affecting the other spouse’s Medicaid eligibility
- Monthly income through the Minimum Monthly Maintenance Needs Allowance (MMMNA), which lets a married Medicaid applicant transfer a portion of their income to their non-applicant spouse so that they can remain in the Community
Medicaid exemption rules are complex, and the specific ones that apply to you depend on your unique situation. Our experienced elder law attorneys can help you understand which of your assets might be exempt and how to structure your finances to maximize these exemptions.
While exemptions provide some protection, they should not be your only Medicaid planning strategy. A comprehensive plan tailored to your unique circumstances will offer the best protection for your assets and future care needs.
Contact Amoruso & Amoruso LLP Today
The compassionate and skilled New York estate planning and elder law attorneys at Amoruso & Amoruso LLP have nearly 60 years of combined legal experience. Our team is committed to helping you prepare for your future so you can receive the care and benefits you need. Our individualized approach and client-centered strategies have earned our attorneys national recognition in the field of elder law. We have the experience and resources to give you the support and advocacy you deserve at this critical moment in your life.
Don’t delay planning to secure access to the Medicaid benefits you need. Call our New York elder law attorneys today or contact us online for a consultation about your specific situation and how it could affect Medicaid eligibility.
