New York Medicaid Qualifications
Medicaid Qualifications Attorneys in New York City
When we reach an advanced age, we may no longer be able to care for ourselves and may require assistance in our day-to-day lives. The concern lies in the fact that long-term care is incredibly expensive—according to a 2020 Genworth survey, the average monthly cost for assisted living care in Nassau County is $5,991, while the state average is $4,800. This figure is simply more than many families can afford—so what can you do? For many, the answer will lie in New York Medicaid qualifications. The most comprehensive level of Medicaid coverage is Nursing Home Medicaid. An individual who qualifies for Nursing Home Medicaid will have the following paid for:
- Standard healthcare services, including doctor visits, hospital stays, lab tests, and prescription drug expenses
- Community-based long-term care services, including home care, adult daycare, and assisted living
Securing Your Legacy with the Help of the Davidov Law Group
Medicaid qualifications can be complex. An experienced New York Medicaid attorney can ensure the assets you have built are properly shielded while still qualifying for Medicaid. So many things must be considered, including tax consequences, strict transfer rules, exemptions, and other intricate issues. Our Nassau County Medicaid planning team can walk you through the process, ensuring you understand how everything works. The Davidov Law Group will discuss the pros and cons of each option, finding a plan that works for you and your family. We do this by listening, answering your questions, and empowering you to make informed decisions regarding your future.
Medicaid planning is not a DIY project and applying for Medicaid long-term care is seldom easy. While most may understand the Medicaid application questions, they may not fully understand the impact of these questions—what the state is really trying to find out. Elder law attorneys specialize in helping with long-term care planning, estate planning, and government benefits. The New York Medicaid qualifications attorneys from Davidov Law Group have a deep understanding of state rules and regulations. We help families by identifying comprehensive strategies that legally obtain and maintain Medicaid eligibility.
Legal Aspects of Home Care Applications or Community Care
New York has offered Medicaid home care programs and services for many years, however, the regulations surrounding these programs have undergone dramatic transformations. These changes involve stricter criteria for financial eligibility, greater restrictions on health eligibility, and the loss of services that were previously covered for new home care applicants. As an example, it was once easier to transfer assets, becoming eligible for needed services almost immediately. Community Medicaid applicants must now provide comprehensive financial records for the “look-back” period, and gift transfers to trusts and family members can disqualify applicants in some cases. There are, however, steps that can be taken to help New Yorkers protect their assets, rights, and quality of life.
- 2022 Eligibility—As of 2022, the Community Medicaid income limit for a single person is $934 per month, with asset limits of $16,800. For a married individual when both spouses are applying, the income limit is $1,367 per month, with asset limits of $24,600. For a married individual when only one spouse is applying, the income and asset limits for that spouse are the same as for a single individual, while the non-applying spouse can have up to $137,400 in assets (the income from the non-applicant spouse is not considered). All income from any source counts toward the income limit (SSDI, Social Security, gifts, annuity payments, IRAs, employment wages, alimony, and pensions). Countable assets include stocks, bonds, investments, vacation homes, savings accounts, checking accounts, and cash. Asset exemptions are listed below.
- “Look Backs”—As of January 2, 2021, there is a look-back period on asset transfers for those applying for Community Medicaid benefits. This means that without considerable spend-down on assets, many who need this care will not qualify. The look-back applies to non-exempt transfers made on or after October. The look-back period is being instituted in phases, starting at three months on January 2, 2021, capping out at 30 months. Applicants for Community Medicaid benefits will be required to submit records of all assets within that period. If transfers of non-exempt assets are found, the applicant will be denied home care services for a “penalty” period—home care in New York would be denied for one month for every $12,844 in non-exempt asset transfers.
Legal Aspects of Nursing Home Care or Chronic Care
Medicaid Nursing Home and Chronic Care have undergone the same changes as Medicaid home care programs, making it potentially more difficult to qualify due to lookback periods. This makes it particularly important to consult with a qualified attorney who is well-versed in New York Medicaid qualifications.
- 2022 Eligibility– As of 2022, the Nursing Home income limit for a single person is $934 per month, with asset limits of $16,800. For a married individual when both spouses are applying, the income limit is $1,367 per month, with asset limits of $24,600. For a married individual when only one spouse is applying, the income and asset limits for that spouse are the same as for a single individual, while the non-applying spouse can have up to $137,400 in assets. Income and asset definitions are the same as those for Community Medicaid benefits.
- “Look Backs”—The look back period for Medicaid nursing home care or chronic care is the same as the look back period for Community Medicaid benefits.
- Asset Exemptions– Non-countable, or exempt assets include personal belongings, household items, a vehicle, burial funds with a cash value up to $1,500, a life insurance policy with a cash value up to $1,500, and one’s primary home when the equity is under $955,000, the applicant lives in the home, and the applicant intends to return.
Medicaid Application Process
There is one Medicaid office open in each borough where you can file an application, or an application can be faxed. Having an experienced New York Medicaid qualifications attorney from the Davidov Law Group is extremely important to ensure your application is filled out properly, and there are no issues that could hold it up.
Some of the most common mistakes made by those applying for Medicaid for nursing home or Community Care include:
- Thinking you have waited too long to take necessary planning steps.
- Giving assets away too early, putting your security at risk; transfers made too early could result in difficult tax issues as well as Medicaid issues.
- Not taking advantage of the safe harbors created by Congress; some transfers are allowed without jeopardizing eligibility for Medicaid.
- Not taking advantage of protections that help the spouse of a nursing home resident, including the purchase of an immediate annuity, petitioning for an increased community spouse resource allowance, or petitioning for an increased income allowance.
- Applying too early or too late.
- Misunderstanding how Medicaid eligibility could potentially affect your home.
- Failing to obtain highly qualified legal assistance.
If your Medicaid application has been denied, the Davidov Law Group will use our experienced guide you through the appeal process—one of the best ways to ensure you receive the long-term care benefits you need. If you received an unfavorable decision regarding Medicaid eligibility, you can request a Fair Hearing with the Office of Temporary and Disability Assistance within 60 days of the notice in order to challenge the denial.
How to Select the Best Medicaid Qualifications Attorneys to Protect Your Family
When you are choosing a Medicaid Qualifications attorney, it is important that your attorney has the following qualifications:
- An in-house certified financial planner
- A significant depth of experience in financial matters
- A holistic view of planning to ensure effectiveness
- A belief in building strong client relationships
- An understanding of your goals prior to making recommendations
Do You Have To Impoverish Yourself To Qualify For Medicaid?
When you hear that many elders rely on Medicaid to pay for long-term care, you may become alarmed. Most people are aware of the fact that Medicaid is only available to people who are financially needy. If a high percentage of seniors are on Medicaid late in their lives, they must be impoverished, right?
Unfortunately, there are people who wind up spending all of their resources paying for long-term care because they did not plan ahead effectively. However, if you are proactive about the implementation of a Medicaid planning strategy, you may never directly experience any financial hardships.
How Can I Qualify For Medicare In New York?
To qualify for Medicaid, your countable assets cannot exceed $14,850. People typically give assets to their loved ones before they apply for Medicaid, but you have to act in advance and get the right legal advice to make sure that you are complying with the Medicaid rules.
There is a five-year look back. You have to complete your gift giving at least five years before you submit your application to obtain eligibility.
Divesting yourself of assets is not necessarily going to result in poverty during this five-year interim. Your home is not considered to be a countable asset, so you would not have to dispossess yourself of ownership. (There is however an $828,000 equity limit in New York in 2015.)
Medicaid would not count the vehicle that you use for transportation, and you can maintain ownership of your personal effects and household belongings. Wedding rings, engagement rings, and heirloom jewelry would not be counted either.
You could continue to draw income during your spend down, so that would not be interrupted. Plus, if you are in a position to do so, you could create an income-only Medicaid trust.
The assets that you convey into the trust would not be counted for Medicaid purposes, and this can be an effective way to divest yourself of direct ownership of assets. Though you could not take back those assets, you could receive income from the earnings of the trust, and this could help you maintain your lifestyle.
Using Medicaid Planning To Protect Your Assets In New York
Most seniors will need long-term care eventually, and it is difficult to pay out-of-pocket, so Medicaid planning is relevant to just about everyone.
Nursing home care is very expensive, and in New York the costs are particularly high. If you have to stay in a nursing home for two years, the bill can exceed $280,000, and some people stay longer. About 10 percent of nursing home residents remain in the facilities for at least five years.
If you take the right steps, you can potentially qualify for Medicaid without losing everything that you intended to leave to your loved ones.
How Davidov Law Group Will Protect Your Family and Preserve Your Legacy
Davidov Law Group is a boutique estate planning and elder law firm located in Lake Success, NY. Led by a husband-and-wife team, we have a passion for helping families plan for the future, including Medicaid planning. As our clients age, we want to be able to provide creative solutions to the many challenges they face. After our family experienced the chaotic and devastating effects that come with a lack of proper planning, our passion for estate planning escalated significantly. We quickly realized that taking some time to proactively plan for the future could have prevented many of the legal complications we witnessed. This inspired us to focus our practice solely on elder law and estate planning.
We empower you to make smart choices about your future. We explain your options, help you explore various strategies, and answer any questions you have regarding Medicaid planning and any other elder law or estate planning issues. We strive to educate you on the law, tailoring strategies specific to your family’s needs while paying meticulous attention to detail. Contact the Davidov Law Group today.