Understanding Long-Term Care & Asset Protection
INTRODUCTION
Medicaid is the primary payer for long-term care in New York. This guide provides the 2026 financial thresholds and rules to help you protect your legacy while securing necessary care.
TYPES OF MEDICAID PROGRAMS
* COMMUNITY MEDICAID: Often called “Home Care,” this covers home health aides, personal care assistants, and adult day care while you reside in your home or an assisted living facility.
* NURSING HOME MEDICAID: Known as “Institutional Medicaid,” this covers 24/7 skilled nursing facility care.
* MEDICAID FOR THE ABD: Provides standard health insurance for those 65+ or with a qualifying disability.
2026 FINANCIAL ELIGIBILITY LIMITS
To qualify, your “countable” income and assets must fall below these New York state thresholds.
SINGLE APPLICANT:
* Monthly Income Limit: $1,835.40
* Asset/Resource Limit: $32,396.00
MARRIED COUPLE (Both Applying):
* Monthly Income Limit: $2,488.60
* Asset/Resource Limit: $43,781.00
*Note for Nursing Home Residents: Once admitted, you are generally required to contribute all income toward the cost of care, keeping only a $50/month Personal Needs Allowance.*
THE “LOOK-BACK” RULES (CRITICAL CAVEAT)
New York treats asset transfers differently depending on the type of care you seek.
* NURSING HOME CARE: There is a strict 60-month (5-year) look-back period. Any gifts or transfers for less than fair market value made within 5 years of your application will trigger a “penalty period” of ineligibility.
* COMMUNITY/HOME CARE: The 30-month look-back is NOT in effect. As of early 2026, the proposed 2.5-year look-back for home care has still not been implemented by the New York State Department of Health.
* Advantage: Currently, individuals can transfer assets and qualify for Home Care Medicaid in the following month without penalty.
* Risk: This “window of opportunity” remains open for now but can be closed by the state with minimal notice.
EXEMPT ASSETS: WHAT YOU ARE ALLOWED TO KEEP
The following assets do not count toward the resource limit:
* PRIMARY RESIDENCE: Exempt up to $1,130,000 in equity if you or a spouse live there.
* RETIREMENT ACCOUNTS: IRAs and 401(k)s are exempt if they are in “payout status” (taking at least the Required Minimum Distribution).
* ONE VEHICLE: One car of any value is permitted.
* BURIAL FUNDS: An irrevocable burial trust of any amount or a designated $1,500 burial fund.
SPOUSAL PROTECTIONS (PREVENTING IMPOVERISHMENT)
If only one spouse needs care, the spouse staying at home (the “Community Spouse”) is allowed to keep significantly more.
* RESOURCE ALLOWANCE (CSRA): The spouse at home can keep up to $162,660 in assets.
* MONTHLY INCOME ALLOWANCE (MMMNA): The spouse at home is entitled to a minimum monthly income of $4,066.50.
PLANNING STRATEGIES FOR EXCESS INCOME & ASSETS
If you exceed the limits, you can still qualify using these legal tools:
* POOLED INCOME TRUSTS: Allows you to “spend down” excess monthly income on your own living expenses (rent, utilities) so it isn’t taken by Medicaid.
* SPOUSAL REFUSAL: A legal right in New York where a spouse refuses to make their income or assets available for the applicant’s care.
* MEDICAID ASSET PROTECTION TRUSTS (MAPT): An irrevocable trust used to protect a home or savings from the 5-year nursing home look-back.
IMPORTANT DISCLAIMER
Medicaid laws are complex and subject to frequent updates. This document is for informational purposes and does not constitute legal advice. Consult with an elder law attorney to create a plan tailored to your specific situation.
FALCONE LAW FIRM
www.falconeattorney.com | 631-607-4529
Offices in Commack, Hauppauge, and Melville