Q: I received a notice that my mom’s Medicaid needs to be recertified. Is this something I should ask an elder law attorney about?
A: Having an experienced elder law attorney overseeing the Medicaid application and recertification processes can certainly better one’s chances of achieving and maintaining Medicaid eligibility.
For 2026, Medicaid has imposed an asset limit of $33,038 for an individual applicant or $44,796 if both spouses are applying for long-term care services. For community-based services, Medicaid’s income limit is $1,836 per individual applicant and $2,489 per couple. With proper planning, income beyond the limits can be maintained to continue to support the expenses of the household. While there are no transfer penalties imposed for home care applicants who have given assets away prior to application, nursing home applicants do have to undergo a five-year lookback review. While most transfers/gifts will result in a penalty period during which Medicaid will not pay for the facility, certain asset transfers will be exempt. Whether both spouses are applying for coverage or just one, the finances of both must be disclosed.
Once someone has been accepted into the Medicaid long-term care program for Community Medicaid (in-home care) or Chronic Medicaid (nursing home care), they will be required to recertify annually. The recertification process ensures that the applicant remains eligible for coverage. The annual review requires updated asset and income verification for the Medicaid applicant, not the spouse. Sometimes Medicaid recipients experience an increase in their assets as a result of the standard accrual of interest, receiving an inheritance, or accepting proceeds from a lawsuit. An attorney can advise what estate planning can be done to prevent ineligibility or a lapse in benefits. Recertification can also prompt determining whether a recipient is receiving the appropriate level of care.
As of the beginning of January 2026, there are 3,812,810 Medicaid recipients within the five boroughs and 662,136 Medicaid recipients in Nassau and Suffolk counties. Medicaid applications and recertifications are processed by each county’s Department of Social Services, or the Human Resources Administration for those receiving care in the five boroughs of New York City. Due to the volume of applications and recertifications, and the millions of dollars expended by the state to provide Medicaid, the system can be unforgiving. Working with an elder law-focused estate planning attorney can help individuals achieve and/or maintain eligibility, while also protecting hard-earned assets so they can eventually be passed on to the next generation.
Recertification also provides the opportunity to review your assets and estate plan. A key estate planning goal for a Medicaid recipient and their spouse is to avoid probate because whatever assets are includable in a deceased Medicaid recipient’s probate estate will be subject to a clawback from Medicaid for services provided during life. Proper planning includes protection of assets for eligibility purposes, as well as after death, to prevent recovery of the value of the services rendered during life.
Erin Cullen, Esq. is an associate attorney at Burner Prudenti Law, P.C., focusing her practice on trusts and estates. Britt Burner, Esq. is the managing partner at Burner Prudenti Law, P.C., focusing her practice on estate planning and 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.