Blogs from 2026

When a parent’s health declines, families often feel like they stepped into a maze of medical terms, financial worries, and legal deadlines. A concerned daughter came to Esther Schwartz Zelmanovitz, PLLC in exactly that moment, unsure how to balance her father’s care, her parents’ finances, and her own limits.

She described feeling overwhelmed, with “a million questions about getting help in the house for him, Medicaid, and how to protect his assets.” A trusted referral led her to attorneys Esther Zelmanovitz and Esther Levinson, and from the first conversation, the tone shifted.

Turning Fear Into a Clear Plan

During the initial consultation, Esther Zelmanovitz listened, anticipated concerns, and walked through each step in plain language, from estate planning to the Medicaid process. This allowed her to explain options to her parents so they could choose what felt right for them.

Because her father was recovering in a rehabilitation center, their first meeting took place by phone. Esther then drafted the estate planning documents promptly and met them at the rehab facility to finalize and execute the plan. This flexible, hands-on approach reflects how Esther Schwartz Zelmanovitz, PLLC tailors legal solutions to real family situations, not just paperwork.

Guidance Through Medicaid and Elder Law

Once the estate planning was in place, attorney Esther Levinson guided the family through the Medicaid application. For someone new to elder law, even the terminology can feel foreign. Esther created a clear chart of assets, described which documents were needed, and explained how to gather them. This structure turned a confusing process into a manageable series of steps.

Throughout, patience and steady communication gave the family confidence. As she shared, the process felt “seamless,” and she called choosing Esther and Esther “the smartest decision I made.”

Compassion, Clarity, and Peace of Mind

Her words capture what we strive for in every matter: *“What stood out most was not only their expertise and professionalism, but also their compassion and personal attention. We always felt that our family’s best interests were their priority.”*

At Esther Schwartz Zelmanovitz, PLLC, we know how overwhelming it can be when a loved one’s health declines and difficult decisions need attention. For decades, our elder law attorneys have helped Long Island families find clarity, protect loved ones, and move forward with greater peace of mind.

If you feel unsure where to begin, start with a complimentary 15-minute introductory call at (516) 347-7356 to talk through your situation and learn your options.

From time to time, a prospective client will ask before their first meeting:

"Why does the attorney need to know about all of my accounts? Isn't that private? Can't we just prepare the documents?"

Most people understand that their estate planning attorney needs their financial information to properly advise them, but occasionally this question comes up, and it is worth explaining why. Many people assume that estate planning simply means drafting a will or trust. In reality, effective estate planning begins with understanding what you own, how you own it, and approximately what it is worth.

Without that information, an attorney cannot provide meaningful, personalized legal advice.

Every Asset Can Affect Your Estate Plan

Every asset you own—and how it is owned—can affect your estate plan. Your home, investment accounts, retirement plans, life insurance, business interests, and beneficiary designations each raise different legal, tax, and planning considerations. Until an attorney understands your complete financial picture, it is impossible to know which planning opportunities apply to you.

For example:

• Is your estate large enough that estate tax planning should be considered?
• Are there retirement accounts that should pass directly to beneficiaries rather than through a trust?
• Is your home owned jointly or individually?
• Should you be considering long-term care asset protection planning?
• Are there assets that should be transferred into a trust after it is created?
• Are beneficiary designations consistent with your estate plan?

The answers to these questions depend entirely on your assets.

The approximate value of your assets is just as important as knowing what those assets are. For many New York families, the value of their home, investments, retirement accounts, business interests, and life insurance can add up much more quickly than they realize.

If your estate may exceed the federal or New York estate tax exemption, your attorney may recommend strategies designed to reduce or eliminate estate taxes, such as lifetime gifting, irrevocable trusts, charitable planning, or other advanced estate planning techniques.

The appropriate strategy often depends on the types of assets you own. For example, transferring retirement accounts to an irrevocable trust is generally not advisable because of the significant income tax consequences, while transferring other assets may produce substantial estate tax savings.

Likewise, many clients are concerned about protecting assets from the cost of long-term care. Whether strategies such as a Medicaid Asset Protection Trust (MAPT) are appropriate depends entirely on the value, ownership, and nature of your assets. Even if long-term care planning is years away, understanding your financial picture today may preserve valuable planning opportunities for the future.

The Details Matter

Knowing what you own is only part of the analysis. Equally important is how you own it.

Three individuals may each have a $1 million investment account, but one may own the account jointly with a spouse, another may have a transfer-on-death designation, and another may have already titled the account in the name of a trust. Although the account values are identical, the legal consequences are very different. Those ownership differences affect whether probate is required, how assets are distributed, what tax planning opportunities exist, and whether your overall estate plan will function as intended.

Just as importantly, your estate planning documents can only control the assets they actually govern. A will does not dispose of retirement accounts, jointly owned property, life insurance, or accounts with beneficiary designations. Likewise, a revocable living trust cannot avoid probate if it is never funded with the appropriate assets.

That is why an estate planning attorney must review not only what you own, but also how each asset is titled and how it will pass at your death. Sometimes the best recommendation is to retitle certain assets into a trust. Other times, changing a beneficiary designation or leaving an asset outside the trust is the better strategy.

Without understanding your complete financial picture, your attorney cannot coordinate your assets with your estate planning documents, and even the best-drafted estate plan may fail to achieve your objectives.

A Comprehensive Plan, Not Just Documents

Every client's financial picture is different, which means every estate plan should be different. A young family with minor children requires different planning than a retired couple concerned about estate taxes or long-term care. A couple with most of their wealth in real estate requires different planning than a couple with substantial retirement accounts. There is no one-size-fits-all solution.

Everything you discuss with your estate planning attorney is protected by the attorney-client privilege and strict ethical rules of confidentiality. The purpose of gathering financial information is not curiosity—it's to ensure that your estate plan accomplishes your goals while minimizing taxes, avoiding probate complications, protecting assets where appropriate, and preventing unintended consequences.

A well-drafted will or trust is only as good as the planning behind it. The true value of estate planning is not the documents themselves, but making sure those documents work together with your assets to accomplish your goals.

If your attorney is taking the time to ask detailed questions about your assets, review how they are owned, and understand your overall financial picture, that is not an unnecessary step—it is one of the most important parts of the estate planning process. Conversely, if an attorney is willing to prepare estate planning documents without first understanding your assets, you should ask whether you are receiving advice that is truly tailored to your family and your goals.

The value of estate planning lies not in the paperwork itself, but in the planning behind it.

A Medicaid application for a loved one often feels confusing and heavy. For RM, working with Esther Schwartz Zelmanovitz, PLLC turned that maze into “a smooth and positive experience.” His recent testimonial shines a light on what thoughtful elder law support can look like when everyone works together with clarity and compassion.

Turning a Complex Process into a Clear Path

RM came to our firm to navigate Medicaid approval for a loved one. Medicaid rules involve many steps and strict requirements, and families often feel unsure about where to begin or what each form means.

Rakesh shared his experience in his own words:

“I worked with Esther and her team to navigate the complex Medicaid approval for a loved one. Thanks to the knowledge, professionalism, and friendliness of the team, the process was a smooth and positive experience. Our attorney, Esther (Esty) Levinson, was a true pleasure to work with. She guided us through every requirement with patience and ensured we clearly understood each step along the way. 

The potentially overwhelming process was made simple and stress-free. I will gladly recommend Esther Zelmanovitz and her firm to anyone seeking compassionate, expert assistance in establishing care for their loved ones.”

- RM

Guidance Rooted in Clarity, Compassion, & Partnership

Medicaid planning at Esther Schwartz Zelmanovitz, PLLC grows out of a simple promise: walk families through each step with care, so they never feel alone or in the dark. Our team has practiced law since 2000, and that long view helps us break down a complex process into clear, manageable actions.

Every family’s situation differs. Goals, health needs, and family dynamics all play a role in the right legal plan. We take time to understand those details and design solutions that fit the client, rather than forcing them into a standard template.

We also value partnership. Our work moves forward most smoothly when clients, and often their family members, stay engaged and responsive. That shared effort builds trust and keeps the process efficient. Working with committed clients like RM makes that partnership especially rewarding.

We know how overwhelming the process can feel, so our focus is on breaking each step down, making sure families feel informed, supported, and confident in every decision. When there is open communication, thoughtful planning, and a dedicated team working alongside the client, even the most complex situations can become manageable, and that’s what makes the process truly successful.

Ready to discuss your Medicaid and elder law options? Contact us online or call Esther Schwartz Zelmanovitz, PLLC at (516) 347-7356 to schedule your free 15-minute introductory consultation.

January 2026 Update

Medicaid planning in New York has remained in a prolonged state of uncertainty for families who rely on community-based long-term care. For years, the proposed Community Medicaid 30-month lookback has been discussed, delayed, and anticipated, yet never fully implemented.

While this has preserved valuable planning opportunities, it has also created understandable confusion for individuals trying to make informed decisions about care, eligibility, and asset protection. As the regulatory landscape continues to evolve, it is important to understand where things currently stand and how that impacts Community Medicaid planning today.

Current Status of the Community Medicaid Lookback & What It Means

Despite statutory authorization enacted several years ago, New York State has still not enforced the Community Medicaid lookback as of the start of 2026. This ongoing delay continues to shape how individuals may qualify for care at home or in assisted living settings.

At this time, the following remains true:

• No active 30-month lookback. Community Medicaid applications for home care, assisted living programs, and other community-based services are not subject to an asset transfer lookback.
• No transfer penalties for community care. Applicants can still receive Community Medicaid benefits without penalties for prior transfers of assets.
• Ongoing Department of Health delays. The New York State Department of Health has repeatedly postponed enforcement and has not issued final implementation guidance.

This regulatory pause preserves planning flexibility, but it should be viewed as temporary rather than permanent.

How This Differs from Nursing Home Medicaid Rules

While Community Medicaid remains exempt from a lookback period, the same is not true for institutional care. Understanding this distinction is essential when planning for future needs.

Key differences include:

• Five-year nursing home lookback. Medicaid applications for nursing home care are subject to a fully enforced five-year lookback period.
• Different risk profiles. Asset transfers that are acceptable for Community Medicaid may create penalties if nursing home care is later required.
• Timing sensitivity. Planning strategies often depend on whether care can remain community-based or may escalate in the future.

This contrast makes advance planning especially important for individuals whose health needs may change over time.

Why Proactive Medicaid Planning Still Matters

Although the absence of an active lookback creates opportunity, it also carries risk. The Community Medicaid lookback could be implemented with limited notice, and individuals who delay planning may lose valuable options.

There are several reasons to act thoughtfully and proactively:

• Regulatory changes can happen quickly. Implementation may occur without extended transition periods.
• Planning is more effective when done early. Asset protection strategies are often more flexible before a crisis arises.
• Care needs can change unexpectedly. Waiting until care is urgently needed may restrict eligibility pathways.

Strategic planning allows individuals and families to respond with clarity rather than urgency.

Looking Ahead with Confidence

The continued delay of the Community Medicaid lookback has preserved a meaningful window for planning, but uncertainty remains part of the equation. Staying informed and working with knowledgeable legal counsel helps ensure decisions made today support both present care needs and long-term financial security.

At Esther Schwartz Zelmanovitz, PLLC, we guide clients through Medicaid planning and applications with a clear understanding of New York regulations, evolving enforcement timelines, and individualized care goals. If you have questions about Community Medicaid eligibility, asset transfers, or long-term care planning, we are here to help.

Call (516) 347-7356 or contact us online to discuss your situation and take proactive steps toward protecting your future.

*Read about the new lookback here.

Dear Clients, Colleagues, and Friends,

As we approach the end of 2025, we want to take this opportunity to thank you for your continued trust in our practice. Elder law and estate planning are deeply personal areas of practice, and it is a privilege to help individuals and families navigate important decisions that protect independence, dignity, and legacy.

This year has brought significant changes to estate planning and elder law, particularly affecting New York State residents. We're committed to keeping you informed about developments that may impact you and your loved ones.

CRITICAL MEDICAID AND ELDER LAW UPDATES

On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law, which included several provisions that directly impact Medicaid planning and long-term care access for New Yorkers. These changes make early planning more important than ever.

Home Equity Limits Being Capped

Beginning January 1, 2028, Medicaid will impose a firm $1,000,000 cap on home equity for long-term care eligibility, with no future inflation adjustments. Currently, the New York home equity limit is $1,097,000 and in 2026, New York will allow a home equity of up to $1,130,000. This change of capping the home equity will make it more difficult for individuals with substantial home equity to qualify for Medicaid long-term care benefits unless specific exceptions apply (such as having a spouse or disabled child living in the home).

Action Item: If you have significant home equity and anticipate needing long-term care in the future, now is the time to explore planning strategies such as irrevocable trusts or other asset protection techniques. Remember that Medicaid has a five-year look-back period for asset transfers, so planning well in advance is essential.

Home and Community-Based Services Restrictions

The new law imposes "budget neutral" requirements on the waivers states use to provide home and community-based services. For New Yorkers, this could lead to reduced availability of services that help seniors remain in their homes rather than entering nursing homes. Programs such as the Managed Long-Term Care (MLTC) and Consumer Directed Personal Assistance Program (CDPAP) may face increased scrutiny and potential limitations.

New York-Specific Home Care Changes

In addition to federal changes, New York State implemented new minimum needs requirements for certain Medicaid-covered home-care services starting September 1, 2025. Applicants for Personal Care Services (PCS), Consumer Directed Personal Assistance Program (CDPAP), and Managed Long-Term Care (MLTC) are now assessed under updated functional need standards, focusing more closely on Activities of Daily Living (ADLs) such as bathing, dressing, walking, and using the bathroom. If you were already authorized for these services before September 1, 2025, you are generally grandfathered under the old rules unless your coverage lapses.

Eligibility Re-determinations

After December 31, 2026, Medicaid eligibility re-determinations will occur every six months instead of annually, requiring more frequent documentation and oversight. This means New York Medicaid recipients will need to maintain careful records and be prepared to provide updated financial information twice per year.

Reduced Retroactive Coverage

The law reduces retroactive Medicaid coverage from three months to two months for applications made after December 31, 2026. This makes timely application even more critical, particularly for New Yorkers who may be facing unexpected nursing home costs.

Nursing Home Reimbursement Challenges

Changes to how nursing homes are reimbursed under Medicaid could lead to financial pressures on New York facilities, potentially resulting in closures, reduced services, or increased private-pay costs. The law also includes a 10-year moratorium on implementing national minimum staffing standards for nursing homes. Given New York's already high cost of long-term care, these changes may significantly impact the availability and quality of nursing home care in our state.

Community Spouse Resource Allowance (CSRA)

On a positive note, the maximum Community Spouse Resource Allowance will increase to $162,660 (up from $157,920 in 2025). This is the amount of assets a healthy spouse can retain when their partner receives Medicaid long-term care benefits. The minimum monthly maintenance needs allowance will increase in 2026, and in New York, where the maximum monthly maintenance needs allowance is utilized, healthy spouses can keep $4,066.50 of income per month (up from $3,948 per month in 2025). These increases provide some additional financial protection for community spouses in New York.

Understanding New York’s Medicaid Look-Back Rules

It’s important to remember that New York Medicaid continues to enforce a five-year look-back period for institutional (nursing home) care. Transfers or gifts made for less than fair market value within five years of applying for nursing home Medicaid can result in a penalty period of ineligibility. While legislation has authorized a 30-month look-back period for community (home care) Medicaid, its implementation remains uncertain at this time. Given these distinctions—and the potential for future changes—advance planning remains essential, particularly for individuals seeking to preserve assets while maintaining eligibility options.

MAJOR ESTATE TAX CHANGES: THE ONE BIG BEAUTIFUL BILL ACT

The OBBBA also brought substantial changes to estate and gift tax planning. This legislation provides rare clarity in an area that has been marked by uncertainty in recent years.

Key Estate Tax Provisions

Federal Estate and Gift Tax Exemption Increase

The federal estate, gift, and generation-skipping transfer (GST) tax exemption has been increased to $15 million per individual ($30 million per married couple), effective January 1, 2026. This represents an increase from the current 2025 exemption of $13.99 million per person. Importantly, this new exemption amount is permanent and will continue to be adjusted for inflation in future years.

What This Means

The long-standing uncertainty surrounding the potential expiration of higher federal exemptions (the “sunset”) at the end of 2025 has now been resolved, providing greater clarity for long-term planning. Families with substantial estates have increased flexibility when structuring wealth transfer strategies, though thoughtful and strategic planning remains essential to fully maximize available tax benefits. Even with higher exemption levels, time continues to be one of the most powerful planning tools—making transfers sooner allows future appreciation to occur outside of a taxable estate.

Critical New York State Estate Tax Considerations

While federal exemptions have increased, New York State maintains its own estate tax with a significantly lower threshold. Currently, New York's estate tax exemption is $7.16 million per person, to increase to $7.35 million per person in 2026. It remains unclear whether New York will increase its exemption to match the new federal amount. This means that even with the higher federal exemption, many New York residents will still face state estate tax exposure.

Important: New York has a unique "cliff" provision where estates valued between 100% and 105% of the exemption amount face a phase-out of the exemption. For estates exceeding 105% of the exemption amount (about $7.7 million in 2026), no exemption is available at all, and the entire estate is subject to New York estate tax from the first dollar. This makes careful planning essential for New York residents with estates approaching or exceeding $7 million.

Annual Exclusion Gifts: Important Limitations

For 2025, individuals can gift up to $19,000 per recipient ($38,000 for married couples) to as many people as they wish without using any lifetime exemption or filing a gift tax return. It appears that this amount will remain the same for 2026.

CRITICAL WARNING: Annual exclusion gifting may not be appropriate for everyone:

• If your estate is well below the federal and New York exemption thresholds (under $7 million for individuals, under $14 million for couples), annual exclusion gifting provides no estate tax benefit and may be unnecessary.
• Annual exclusion gifts can trigger Medicaid penalties. Any gifts made within five years of applying for Medicaid long-term care benefits will result in a period of ineligibility. For example, a gift of $19,000 could result in more than one month of ineligibility based on current New York Medicaid rules. If you anticipate needing long-term care within the next five years, gifting could jeopardize your Medicaid eligibility.

Bottom Line: Estate tax planning and Medicaid planning often have conflicting goals. Making gifts to reduce estate taxes can create Medicaid ineligibility. Always consult with an attorney who understands both areas before making any substantial gifts.

WHY PLANNING MATTERS NOW MORE THAN EVER

While the increased federal exemptions may lead some to believe estate planning is no longer necessary, nothing could be further from the truth—especially for New York residents. Here's why thoughtful planning remains essential:

• New York State Estate Tax: With a $7.35 million exemption in 2026 and harsh cliff provisions, New York estate tax planning remains critical for many families, regardless of the higher federal exemption.
• Medicaid Planning Urgency: The new home equity cap and service restrictions make advance Medicaid planning crucial. The five-year look-back period means you need to plan today for potential care needs years from now.
• Protection Beyond Taxes: Estate planning ensures your wishes are honored, protects vulnerable family members, avoids probate delays, and provides for smooth business succession.
• Long-Term Care Costs: New York has some of the highest long-term care costs in the nation. Proper planning is essential to protect your assets while ensuring access to quality care.
• Balancing Competing Goals: Estate tax minimization and Medicaid eligibility often require different strategies. Professional guidance can help you navigate these competing priorities.

RECOMMENDED ACTIONS FOR YEAR-END

As 2025 comes to a close, you should consider the following action items:

• Review Your Existing Estate Plan: Ensure your documents reflect current New York and federal law, your wishes, and your family situation. If your plan was created before recent changes, it likely needs updating.
• Evaluate Your Estate Tax Exposure: If your estate approaches $7 million, consult with an attorney about strategies to minimize New York estate tax, such as lifetime gifts, trusts, or charitable planning.
• Start Medicaid Planning Early: Don't wait until care is imminent. With the five-year look-back period for nursing home care and the possibility of implementation of the look-back for home care services, along with the new restrictions taking effect in 2028, now is the time to explore irrevocable trusts and other asset protection strategies.
• Be Cautious About Gifting: Before making any gifts—even annual exclusion gifts—consider whether you might need Medicaid within the next five years. A seemingly harmless gift today could cost you eligibility when you need it most.
• Update Beneficiary Designations: Review beneficiaries on retirement accounts, life insurance policies, and bank accounts to ensure they align with your overall plan.
• Document Your ADLs: If you may need home care services, work with your doctor to ensure your functional limitations are clearly documented in your medical records.

LOOKING AHEAD TO 2026

The estate planning and elder law landscape continues to evolve, particularly for New Yorkers who must navigate both state and federal regulations. While we now have greater certainty regarding federal estate tax exemptions, several critical questions remain: Will New York increase its estate tax exemption to match the federal amount? How will the state implement the new Medicaid restrictions? What impact will reduced federal funding have on New York's long-term care system?

We're monitoring these developments closely and will keep you informed as answers emerge. In the meantime, we encourage you not to delay in addressing your planning needs. The combination of New York's unique tax structure, impending Medicaid restrictions, and the five-year look-back period creates both challenges and opportunities that require prompt attention.

OUR COMMITMENT TO YOU

As we close out 2025, we extend our sincere thanks to our clients, their families, and our professional colleagues for your continued confidence and collaboration.

Whether you're creating your first estate plan, updating existing documents, navigating Medicaid eligibility, or planning for long-term care, we're here to help you protect what matters most. Please reach out to us to schedule a review or for anything else that we can assist you with.

Wishing you and your loved ones a healthy, peaceful, and prosperous New Year.

Warm regards,

Esther Zelmanovitz

DISCLAIMER: This newsletter is provided for informational purposes only and does not constitute legal advice. Estate planning and elder law are complex areas, and the information provided here is general in nature. Every situation is unique, and you should consult with an attorney about your specific circumstances. The information in this newsletter is current as of December 2025 and is subject to change. This newsletter is directed primarily to New York State residents and reflects New York law and practice.

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