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

What New York Residents Need to Know

(Especially Important for Nursing Home Care)

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The Bottom Line

New York has changed how Medicaid works in 2026.

Some changes make Medicaid stricter and more expensive when someone has given away money or property. Other changes make the application process simpler. Both are important to understand before applying for Medicaid.

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1. What Is a Medicaid Transfer Penalty?

If a person gives away money or property, or sells something for less than it is worth, and later applies for nursing home Medicaid, New York may impose a penalty period.

A penalty period means:
* Medicaid will not pay for nursing home care for a certain number of months
* The nursing home must be paid out-of-pocket during that time

Important:
* These penalties mainly apply to nursing home Medicaid
* They generally do not apply to basic “Community Medicaid”

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2. How New York Calculates the Penalty

New York does not use one statewide number. Instead:

* The State is divided into regions (New York City, Long Island, Hudson Valley, Central NY, Western NY, etc.)
* Each region has a monthly nursing home cost
* The penalty is calculated as follows:

> Amount given away ÷ Regional monthly nursing home cost = months Medicaid will not pay

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3. What Changed for 2026
4. Nursing Home Cost Numbers Are Higher

For 2026, New York increased the regional nursing home cost numbers.

What this means:
* The same gift now causes a longer Medicaid penalty than in prior years
* Even modest gifts can result in many months without Medicaid coverage

Example:
* Years ago, a gift might have caused a 6–7 month penalty
* In 2026, that same gift could cause 9–12 months of private pay, depending on the region

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1. Timing Matters More Than Ever

A very important rule:

Medicaid uses the nursing home rate in effect when you APPLY — not when the gift was made.

This means:
* Gifts made years ago are still affected by today’s higher rates
* Waiting to apply can make the penalty worse

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1. Penalties Can Be Long and Severe

* There is no maximum penalty length
* Partial months still count
* Medicaid will not help during the penalty — even if the person has no money left

Families are often shocked to learn that Medicaid provides no assistance at all during the penalty period.

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1. Medicaid Planning Is Riskier Now

Because of:
* Higher regional rates
* Strict enforcement by Medicaid offices
* Less flexibility than in the past

Mistakes in planning can now result in huge nursing home bills.

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4. What Medicaid NO Longer Requires (Good News)

While some rules are stricter, New York Medicaid has also made one helpful change.

You No Longer Have to Apply for Other Benefits First

In the past, Medicaid often required applicants to:
* Apply for Social Security or other benefits first
* Prove those applications were filed before Medicaid would approve coverage

This is no longer required.

Medicaid:
* Will not force you to apply for other benefits
* Will not delay or deny Medicaid because another benefit application was not filed
* Can process Medicaid more quickly and with less paperwork

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Important Clarification

* Medicaid still counts income you actually receive
* But Medicaid cannot force you to chase other benefits just to qualify

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5. Key Takeaways

* Giving away money or property can delay Medicaid coverage
* Delays are now longer in 2026 due to higher nursing home cost numbers
* Medicaid uses the rate in effect when you apply, not when gifts were made
* Poor planning can lead to months of uncovered nursing home bills
* The application process is simpler, but the financial risks are higher

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Final Thought

Medicaid rules are changing quickly, and outdated advice can be costly. Advance planning is more important than ever, especially before nursing home care is needed.

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This handout is for general educational purposes and is intended for client distribution.

As the population of the United States continues to age, the demand for healthcare services, particularly for long-term care, has been steadily increasing. In response to this trend, states like New York have been implementing new Medicaid rules to adapt to the changing needs of their aging population. These rules, which will go into effect in 2025, aim to streamline the Medicaid process and ensure that eligible individuals receive the care they need in a timely and efficient manner.

One of the key changes to the Medicaid rules in New York for 2025 is the implementation of a new eligibility criteria for long-term care services. Under the new rules, individuals will need to meet stricter income and asset requirements in order to qualify for Medicaid coverage for long-term care. This means that some older adults who were previously eligible for Medicaid may now find themselves ineligible under the new rules, placing a greater financial burden on themselves and their families.

In addition to changes in eligibility criteria, the new Medicaid rules in New York for 2025 also aim to improve the quality of care provided to older adults by implementing new regulations for long-term care facilities. These regulations include stricter guidelines for staffing levels, training requirements for caregivers, and standards for the quality of care provided. While these changes are intended to ensure that older adults receive the highest quality of care possible, they may also result in increased costs for long-term care facilities, which could be passed on to residents in the form of higher fees.

Furthermore, the new Medicaid rules in New York for 2025 also emphasize the importance of preventative care and wellness programs for older adults. By promoting healthy lifestyles and early intervention, these programs aim to reduce the need for costly long-term care services in the future. However, implementing these programs may require significant resources and investment, which could strain the already limited resources of the Medicaid program.

Overall, the new Medicaid rules in New York for 2025 have the potential to have a significant impact on the aging population in the state. While the changes aim to improve the efficiency and quality of care provided to older adults, they may also pose challenges for those who are no longer eligible for Medicaid coverage or who may face increased costs for long-term care services. It is crucial for policymakers to carefully consider the implications of these new rules and work towards finding solutions that balance the needs of the aging population with the resources available through the Medicaid program. Only through thoughtful planning and collaboration can we ensure that older adults in New York receive the care and support they deserve in their golden years.

Imagine this: a sudden illness or accident leaves you unable to manage your own affairs. Your mortgage payment is due, your Con Ed bill needs to be paid, and a crucial financial decision needs to be made about your retirement account. Who has the legal authority to step in and handle these things for you? If you’re like many New Yorkers, the answer might be a frightening “no one.”

This is where one of the most vital documents in estate planning comes into play: the Durable Power of Attorney (POA). While a Will dictates what happens to your assets after you pass away, a Power of Attorney protects you and your finances while you are still living. It is a legal document where you (the “principal”) designate a trusted person (your “agent”) to make financial and legal decisions on your behalf.

Why is a POA So Crucial in New York?

Without a valid Power of Attorney in place, your family cannot simply access your bank accounts or manage your property if you become incapacitated. They would be forced to petition the New York courts to have a guardian appointed for you. This process, known as an Article 81 Guardianship Proceeding, can be a lengthy, expensive, and public ordeal. It adds immense stress to your loved ones during an already difficult time and puts a judge, not you, in control of who manages your life.

By creating a Power of Attorney, you maintain control. You choose the person you trust most to handle your affairs. This document can be tailored to your specific needs, granting your agent broad powers or limiting them to specific transactions. Under New York law, a POA is “durable” by default, meaning it remains in effect even if you later become incapacitated, which is precisely when it’s needed most.

Choosing Your Agent: A Matter of Trust

Your agent acts as your fiduciary, legally obligated to act in your best interest. This role carries immense responsibility, so your choice is critical. Your agent should be someone who is not only trustworthy but also organized, responsible, and capable of handling financial matters. You should also name at least one successor agent who can step in if your first choice is unable or unwilling to serve.

Whether you are 35 and just bought your first home or 75 and enjoying retirement, a Power of Attorney is a non-negotiable part of a complete life plan. It’s an inexpensive tool that provides invaluable peace of mind, ensuring your financial life can continue seamlessly even if you are unable to manage it yourself. It protects your autonomy, spares your family from a potential court battle, and keeps your private affairs private. Don’t wait for a crisis to strike—planning today is the greatest gift you can give your future self and your family.

Disclaimer: This blog post is for informational purposes only and does not constitute legal advice. You should consult with the Falcone Law Firm for advice regarding your individual circumstances.

A power of attorney is a legal document that allows you to appoint someone to act on your behalf in financial and legal matters. You may need a power of attorney if you are unable to manage your own affairs due to illness, injury, disability, or absence. A power of attorney can give you peace of mind and ensure that your wishes are followed.

New Power of Attorney Law

In New York, there is a statutory short form power of attorney that you can use to create a valid and enforceable document. This form has been updated in 2021 to make it easier and more flexible for you to use. Here are some of the main features and benefits of the new power of attorney law in New York:

• You don’t have to use the exact wording of the statutory form, as long as your document substantially conforms to it. This means you can customize your power of attorney to suit your needs and preferences, as long as you don’t change the meaning or intent of the form.
• You can include gifting provisions in the modifications section of the form, instead of having to execute a separate statutory gifts rider. This simplifies the process and allows you to authorize your agent to make gifts on your behalf, such as for estate planning or tax purposes.

• You can sign your power of attorney by yourself or by directing another person to sign for you in your presence. This makes it easier for you to execute your document if you have physical limitations or difficulties with writing.
• Your power of attorney must be signed by two witnesses who are not named as agents or beneficiaries of gifts. One of the witnesses can also be the notary public who acknowledges your signature. This adds an extra layer of protection and verification for your document.
• Your power of attorney will automatically include all the powers listed in the statutory form, unless you cross out any powers that you don’t want to grant. You can also add any additional powers or limitations in the modifications section. This gives you more control and flexibility over what your agent can and cannot do on your behalf.
• Your power of attorney will take effect immediately upon signing, unless you specify otherwise in the modifications section. You can also make your power of attorney durable, which means it will remain valid even if you become incapacitated. This ensures that your agent can act for you when you need it most.
• Your power of attorney can be revoked by you at any time, as long as you are mentally competent. You can revoke your document by notifying your agent and any third parties who rely on it, such as banks or government agencies. You can also revoke your document by executing a new power of attorney that states that it revokes any previous ones.
• Your agent must act in your best interest and in accordance with your reasonable expectations. Your agent must also keep records of all transactions and decisions made on your behalf, and provide them to you or anyone else that you authorize. Your agent can be held liable for any misconduct or negligence that causes harm to you or your property.

If you want to create a power of attorney in New York, you can use the statutory short form provided by the state. The FALCONE LAW FIRM can help you if you have any questions or concerns about your power of attorney, especially if it involves complex or sensitive matters.

A power of attorney is an important tool that can help you plan for the future and protect your interests. By using the new statutory short form in New York, you can create a power of attorney that is simple, flexible, and effective.

Caring for children with special needs is a challenging yet rewarding journey. The crucial key to navigating this path successfully lies in an often-overlooked aspect: self-care. This article, courtesy of Falcone Law Firm, focuses on empowering parents of special needs children with essential self-care strategies, ensuring they not only survive but thrive in their caregiving roles.

The Importance of Self-Care in Special Needs Parenting

Self-care isn’t about self-indulgence or negligence toward responsibilities. It is about replenishing oneself to better manage the demands and stressors of life, particularly when caring for a child with special needs. Neglecting self-care can lead to exhaustion, both physically and emotionally, impairing the quality of care given to your child.

Develop Awareness of Compassion Fatigue Triggers

Understanding and acknowledging your fatigue triggers is vital in forming a self-care plan. Prolonged periods of intense care, emotional stress, or even lack of proper sleep could be potential triggers. By keeping a fatigue diary or simply being more self-aware, you can identify patterns and take appropriate steps to manage your energy levels more effectively.

Create Personal Goals to Work Toward

Having personal goals beyond caregiving can serve as a stress outlet and bring a sense of balance to your life. These goals could be related to physical fitness, a hobby, or even your professional life. Remember, it is not about the magnitude of the goal but the sense of accomplishment and personal growth it brings.

Implement a Self-Care Plan, and Seek Support

From meditation to workout routines, self-care strategies can be varied. The essence lies in finding activities that bring you joy, relaxation, and a sense of peace. Also, seeking professional help when needed, be it a respite caregiver, financial advisor, or mental health counselor, should never be viewed as a sign of weakness, but rather as a strategic move in your self-care plan.

Is It Time for a New Job?

Seeking new employment may seem daunting, but remember, you’re not alone in this journey. Many employers today understand the unique challenges that parents like you face and offer supportive work environments. Whether it’s flexible hours, remote work options, or supportive company policies, there are many opportunities out there that can provide the work-life balance you need. 

Creating a great resume is key to standing out in your job search, and using free online resume templates can provide the perfect starting point. This may help you to effectively showcase your skills and experiences, ensuring you make a lasting impression on potential employers.

Forge a New Path as an Entrepreneur

One possible path that offers greater flexibility is becoming your own boss. Running your own business can provide the adaptability that traditional employment often lacks, allowing you to create a work schedule tailored around your child’s needs. However, this path requires careful planning and strategic decision-making. 

You need to develop a robust business plan that outlines your venture, from product or service offerings to target market analysis. A comprehensive marketing strategy is crucial too, as it will guide how you attract and retain customers. Additionally, registering your business as an LLC can offer essential protection for your personal assets against potential business liabilities.

A Tidier, Organized Home Can Reduce Stress

An organized home can significantly reduce daily stress levels. Simple hacks for cleaning stubborn areas, especially children’s playrooms, and bedrooms, can help keep the chaos at bay. Not only does it provide a serene environment, but it also creates a sense of control, reducing stress levels associated with caregiving. 

Caring for a special needs child is a unique journey filled with challenges and triumphs. Throughout this journey, it is essential to keep the theme of self-care at the forefront. Implementing the self-care strategies outlined in this article can help improve your quality of life and ensure that you are at your best to care for your child.

 

You can contact the author at Emily Graham <emily@mightymoms.net>

Falcone Law Firm is proud to announce we are Lead Counsel Verified! Contact us today to find out more.

It is not uncommon for people to give their spouses power of attorney when developing an estate plan in the event of their death or incapacity. A power of attorney is a very powerful document that gives the agent the ability to gift your assets and to sign your name on documents. However, if you should get divorced, you obviously do not want your spouse to still have this power. The question then becomes whether the divorce itself will automatically revoke a power of attorney, or if there are extra legal steps you need to take to do this yourself.

In most places around the country, a divorce does not automatically revoke an attorney-in-fact designation. The only exceptions are for power of attorney documents made in the following states: Alabama, California, Colorado, Illinois, Indiana, Kansas, Minnesota, Mississippi, Ohio, Pennsylvania, Texas, Washington, and Wisconsin.

For more information on handling power of attorney and other estate planning documents after your divorce, meet with an experienced Estate Planning attorney at the Falcone Law Firm.

Significant Increases to Medicaid Resource Limits in 2023

There’s good news for seniors who are either on Medicaid Community or Nursing home Care for 2023 or who might need those services in 2023.

Social Security Income (SSI) beneficiaries will receive an 8.7 percent annual cost of living adjustment in 2023.

Income Levels for Medicaid Will Change

Medicaid recipients with an income spend-down will also receive notice in the coming weeks of significant changes to the 2023 Medicaid income and resource limits. The Income limit for a single individual on Community (Home Care) will go up from $934 in 2022, up to $1,563 in 2023.

Some of the common questions asked about the amount of assets you are allowed for 2023 are as follows:

Q: How much can I keep in my name if I am on Nursing Home or Community Medicaid or will apply in 2023?
A: The resource level for an SSI-related individual will increase from $16,800 ($24,600 for a couple) to $28,133.00 for an individual ($37,902 for a couple) effective January 1, 2023.

Q: What if I am working and need Medicaid?
A: You may be eligible for the Medicaid Buy-In program for Working People with Disabilities. The Resource levels for that program will also increase on January 1, 2023. Currently there is a fixed level of income of $20,000 for individuals and $30,000 for a couple. It will increase to $28,133.00 for an individual ($37,902 for a couple) effective January 1, 2023.

Effective date: The new income and resource levels are effective for January 1, 2023, and apply to new applications and requests for an increase in coverage on or after January 1, 2023.

This is great news for people with disabilities or older adults who are just over the current threshold! This increase will reduce the number of Medicaid recipients who have excess income.

Earlier this month, the Falcone Law Firm sponsored the Second Annual Joe Winters Memorial Golf Outing. We are proud to have been able to contribute to their noble cause.

Giving Back to Our Community

At the Falcone Law Firm, we understand the importance of giving back to our community. We pride ourselves on supporting causes that impact individuals and families throughout Long Island, and the Winters Center for Autism holds a special place in our hearts.

To learn more about the Winters Center for Autism or to support their cause, please visit https://www.winterscenterforautism.com/ or call (631)635-1169.