Medicaid Attorney in NYC & Long Island

Medicaid Planning for the Cost of Long Term Care

The high cost of nursing home and home health aides in New York has made Medicaid long term care planning critically important for seniors of all income levels and their families. In fact‚ most seniors will likely require some form of long-term care. Sadly‚ many of them are unprepared for the significant financial burdens long term care places on their family’s hard earned savings. Financial devastation looms large for a family facing ongoing care at a rate of $10,000 or more per month for home health care and upwards of $15,000 per month for Nursing Home care.

By engaging in estate planning while you are healthy, you can minimize your asset exposure if a time comes when you need to rely on Medicaid. The gold standard for asset protection, is the creation and funding of an Irrevocable Trust. If you were to fund an Irrevocable Trust with certain assets and more than 2.5 years for Community Medicaid or 5 years for Chronic Medicaid pass, Medicaid will not look to those trust assets as available to pay for your care. Learn more about the Medicaid Asset Protection Trusts.

It is important to note, that even without planning, New York law allows certain exempt transfers that can be done on the eve of entering a nursing home to preserve some or all of the assets - such as spousal refusal and transfers to disabled children.

Medicaid Eligibility in New York State

What is Medicaid?

Medicaid is a joint federal-state program‚ Medicaid provides medical assistance to individuals‚ including those who are 65 or older‚ disabled or blind who meet certain asset and income guidelines. Medicaid is the single largest payer of nursing home bills in America and serves as the option of last resort for people who have no other way to finance their long-term care.

 

It is important to understand that there are two types of Medicaid long-term care with very different eligibility guidelines:

 

Medicaid Nursing Home Care (Chronic)

Assets

An applicant for Nursing Home Medicaid (Chronic Medicaid) cannot have assets that exceed $15,750.00, excluding retirement savings as long as they are in the required pay-out status, life insurance policies with a cash surrender value of no more than $1,500.00, and an irrevocable pre-paid burial account. If married, the spouse not receiving care (community spouse) can have a maximum of $128,640.00 - unless spousal refusal is utilized.

When an applicant applies for Nursing Home Medicaid, the local Department of Social Services (DSS) will “look-back” five years at all financial accounts in the name of the applicant and the applicant’s spouse. The purpose of this look-back is to determine whether the applicant (or spouse) has transferred any monies out of his or her name in the five years immediately preceding. To the extent that assets have been transferred, DSS will penalize the applicant which will result in a period of ineligibility for Medicaid. For approximately every $13,400.00 transferred, Medicaid will not pay for one (1) month in a nursing home.

Income

All income of Medicaid recipient above $50.00 must go toward his or her care. There are certain exceptions for married couples that allow the spouse who is still living in the community to use a portion of the Medicaid spouse's income in order to bring the community spouse's monthly income up to a maximum of $3,216.00.

Medicaid Home Care (Community)

The guidelines for Community Medicaid (home healthcare aides) in New York State recently changed. Effective later this year, a  look-back period of thirty months (2.5 years) will apply for all transfers made during that period. Prior to this new law, Medicaid planners could make transfers to an irrevocable trust without causing a period of ineligibility.

Assets

An applicant for Home Care Medicaid (Community Medicaid) also cannot have "available resources" that exceed $15,750.00. As mentioned above, certain assets are considered exempt resources when determining eligibility.

Income

A recipient receiving Medicaid home care can keep $895.00 of income each month. Any amount over the $895.00 is considered “excess income.”

However, in New York we can use a Pooled Income Trust to capture the excess income to pay bills on behalf of the Medicaid recipient. Pooled Income Trust are established and managed by non-profit organizations for the benefit of the disabled beneficiaries.

Hiring a Lawyer for Medicaid

Our Medicaid attorneys have the experience and the expertise to help avoid the financial ruin associated with the high cost of long-term care. With locations in Westhampton Beach, E. Setauket and New York City, we know the nuances of each county and can explain Medicaid eligibility and implement the planning and application process. Let us supply solutions to your Medicaid Assisted Living, Nursing Home, and Home Care needs.

Scroll to Top