Long Island Medicaid Planning Attorney
Few of us want to consider planning for long term care, however, without this planning, you could find yourself unable to self-pay for an assisted living facility or nursing home, yet also unable to qualify for Medicaid. Medicaid is a “means-tested government entitlement,” which means your income and resources must be below a certain level to entitle you to benefits. Proper planning can both protect your assets and ensure you are entitled to Medicaid benefits should the need arise.
Many people are misinformed regarding Medicaid planning issues, believing there is nothing they can do to protect their assets. In many cases, assets can even be protected at a very late date, although the earlier the planning begins, the better your assets can be protected.
The New York State Department of Health lists the annual estimated 2018 nursing home rate in Long Island as $156,636, with New York City nursing home rates at about $147,828. Our attorneys at Esther Schwartz Zelmanovitz, PLLC are highly skilled and knowledgeable in the use of Medicaid-exempt transfers, irrevocable trusts, and combinations of loans and gifting as well as other planning techniques as tools to protect assets as a part of Medicaid planning.
We can assist you with the Medicaid application process, while always ensuring your interests are the primary concern. Early planning is always the best course of action; our team will ensure your Medicaid application is accurately and professionally prepared.
Recommended reading: NYS Income and Resource Limits for Medicaid (2025)
New York Long Term Care Planning
Any service required to meet the personal care needs of an individual can fall under long term care. A person turning 65 today has nearly a 70 percent chance of needing some level of long-term care services or support in their remaining years. Overall, women will require an average of 3.7 years of long term care services or support, while men will require an average of 2.2 years of long term care services or support.
Specifically, the following percentages of people aged 65 and older will need the stated levels of care at some point in their life:
- 69% will require some type of long term care service
- 59% will receive unpaid care in their home for at least one year
- 42% will receive paid care in their home for less than one year
- 35% will receive care in a nursing home for at least one year
- 13% will receive care in an assisted living facility for less than one year
- 37% will receive some type of facility-based care for at least one year
Common Questions about Medicaid
What is Medicaid planning?
Statistically, many of us will need to reside in a nursing home or similar facility. If you don’t have long-term care insurance, or cannot afford the ever-increasing cost of such insurance, then the remaining options for paying for a nursing facility are to pay out-of-pocket or to rely on government programs that may cover eligible individuals for their final stage of care. There are legal strategies available to arrange your affairs in a way to ensure that you will qualify for Medicaid, while also preserving much of your estate for your final beneficiaries. An experienced elder law attorney can help educate you on the options available to you and your family.
Am I eligible for Medicaid?
There are asset-level or wealth limits to be eligible for state Medicaid. There are also income limits. However, there are permissible and legal strategies to move toward becoming eligible for Medicaid if you are currently in excess of these limits. Speak with an elder law attorney today to explore your options and how you can protect your estate for your loved ones.
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Medicaid Planning in New York
Medicaid is a “means-tested” program that addresses the health care needs of those who cannot afford to privately pay for long term care. Medicaid is jointly funded between federal and state for those who are low-income. An individual must be over the age of 65 or disabled, blind, eligible for public assistance, or a recipient of Supplemental Security Income (SSI) to qualify for Medicaid. Further, the individual may only have minimal assets to qualify for Medicaid benefits in New York.
When an application for Medicaid nursing home care is made, in addition to confirming that a person currently meets the financial eligibility requirements, Medicaid rules require a determination as to whether any gifts or transfers by the applicant were made within the prior five years.
The Medicaid nursing home care application requires applicants and their spouses to disclose all financial transactions for 60 months preceding the nursing home application. This is known as the “look-back” period. If an applicant or his or her spouse transferred money or property within this five-year period, Medicaid may impose a “penalty” in the amount of the transfer.
For example, if an individual transferred her home valued at $200,000 to her children or a trust, and then needed nursing home care two years later, Medicaid may approve an application for nursing home care based on the applicant’s current financial means, but impose a “penalty” which would require the applicant to cover the first $200,000 of her own nursing home costs before Medicaid would step in to pay for the care. This is obviously a problem as the applicant no longer has $200,000 to pay for this care.
In New York State, the five-year look-back period is only imposed on nursing home applications, with no look-back period for home care. Because Medicaid long term care has strict rules, including the “look-back” period, it is important to start Medicaid planning as early as possible. Our attorneys at Esther Schwartz Zelmanovitz, PLLC can help you with all the requirements which determine your Medicaid eligibility for benefits.