Q: My wife may require nursing home care. I was considering applying for Medicaid but I have heard that we could lose everything if we accept assistance through the Medicaid program. Is this correct?
A: With 10,000 baby boomers turning 65 every day, long-term care planning has become an increasingly important issue across the United States, including in New York. As the population ages, more individuals will require long-term care services and supports, highlighting the need for prudent planning to cover future care costs. There have been recent developments in New York on Medicaid eligibility rules and asset protection strategies.
New York's Medicaid program covers long-term care services for qualifying low-income individuals. Long term care includes personal aides in the home and nursing home care. To be eligible, applicants must meet income and asset limits that are adjusted periodically.
In 2024, the asset and income limits for New York Medicaid remain the same:
As of January 2024, the asset limit for Medicaid long-term care services is $30,182.00.
For institutionalized Medicaid (care in a nursing facility), the income allowance is $50.00 per month with the balance of the income going to the nursing home.
For community Medicaid (care in the community), the income allowance is $1,677.00 for an individual in 2024, plus $20.00 disregard. Any excess income can be preserved through the use of a Pooled Income Trust.
Recent changes to New York's Medicaid rules and related costs include:
In 2024, the maximum Community Spouse Resource Allowance (CSRA) increased to the greater of: $74,820 or ½ of the married couple's resources, not to exceed $154,140. In 2023, the maximum allowable to a spouse was $148,620.
The Home Equity Limit increased from $1,033,000 to $1,071,000.00.
The Medicaid regional rates for nursing homes increased all over the state, eg the Long Island rate increased from $14,136 to $14,668.
Co-insurance for skilled nursing care for days 21 to 100 increased from $200.00 to $204.00 per day.
The Medicare Part B standard premium increased from $164.90 to $174.70.
To take advantage of these Medicaid programs, a comprehensive estate plan is usually necessary. Outdated estate plans can lead to unintended consequences for Medicaid eligibility or failure to fully utilize New York Medicaid eligibility strategies. The creation of trusts and gifting of assets are two time-tested strategies that can help protect savings.
At the federal level, proposals that could impact long-term care planning include changes to Medicaid eligibility rules, increased tax incentives for long-term care insurance, and new programs to support family caregivers. Unfortunately, major reforms have stalled recently.
With proper preparation, New York seniors can develop plans to cover future care costs while maximizing assets for a healthy spouse and preserving assets for the next generation. Consulting experienced elder law attorneys is crucial to navigate the complex web of Medicaid rules, long-term care insurance, and estate planning opportunities. Medicaid is a federally funded program so changes at the federal level can impact the states. Staying up to date on federal policies can help inform planning. As federal and New York policies evolve, seniors should periodically review their plans. Prudent strategies enacted today can help protect hard-earned savings in the future.
Brittni Sullivan, Esq. is an attorney at Burner Prudenti Law, P.C. focusing her practice areas on Elder Law. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.