What Long Island Residents Need to Know About Medicaid Planning in New York

Many people approaching retirement age in New York delay planning for Medicaid, not recognizing that this neglect can threaten their ability to sustain their standard of living in the coming years. Whether someone plans to stay in their home or eventually transition to a nursing home, there are steps they should start taking over half a decade in advance of their Medicaid application.

At Sheryll Law, P.C., we help residents on the East End of Long Island avoid missteps that could threaten their retirement or nursing home residence plans. Below, we cover several points New York residents should know about how to plan for Medicaid. Contact us today to schedule a consultation with an experienced and knowledgeable Medicaid planning attorney.

New York Residents May Not Be Able to Access Medicaid Benefits If They Do Not Plan Properly

Medicaid in New York is not limited to low-income individuals, pregnant women, the disabled, or residents over 65. Many upper-middle-class people receive Medicaid assistance, which helps them with expenses for hospital care, medications, physician services, supplies, and long-term care in their homes or at a skilled nursing facility.

Do not wait to plan until it is almost time for nursing home assistance. New York residents who do not plan properly may be ineligible for Medicaid during their time of need, keeping them out of long-term programs. For those who do not plan in advance, Sheryll Law, P.C works with clients to determine a strategy that helps protect as much assets as possible while trying to minimize penalties. At Sheryll Law, P.C., our experienced Medicaid planning attorneys have tools and strategies designed to help clients avoid many unforeseen difficult situations ahead of time.

Determining Eligibility for Medicaid in New York

Medicaid eligibility varies across programs in New York and is based on income, assets, and marital status. One spouse’s assets may also affect the eligibility computation of the other spouse. The Community Spouse Resource Allowance (CSRA) protects a non-applicant spouse from impoverishment as the other spouse seeks Medicaid eligibility.

Who Qualifies for Medicaid? To be eligible for Medicaid in New York, an applicant who is 65 years of age or older must be one of the following:

  • A New York state resident
  • A U.S. national, citizen, or permanent resident
  • Meet financial and medical eligibility requirements

If an applicant is not 65 years of age or older, they must be at least one of the following:

  • Pregnant
  • Blind
  • Responsible for a child under 18 years of age
  • Disabled
  • A household family member of someone with a disability

One of the most critical points to understand about Medicaid planning in New York is the look-back period of five years. As a needs-based and income-based government program, Nursing Home Medicaid checks past transfers during the look-back period to identify whether an applicant sold or gifted assets for less than their fair market value. Such actions can severely compromise a Nursing Home Medicaid application.

Start Planning Over 5 Years Before Applying for Medicaid in NY

Some of the strategies we incorporate into Medicaid planning include:

  • Placing assets into irrevocable trusts
  • Gifting cash and assets to family members
  • Purchasing long-term care insurance
  • Purchasing annuities
  • Transferring one’s home deed to chosen beneficiaries

Before taking action on any of these items, speak with an estate planning attorney. Every situation is different and what may have worked for a neighbor or family member may not be the best strategy for you. For example, gifting assets can result in penalties and completing a quick deed transfer to a beneficiary can make it irrevocable and have negative future consequences. If you are interested in how to protect your assets and your home from Medicaid click here to watch our webinar, How to Prepare for the 5-Year Lookback.

It is important to note that you must take these steps over five years before applying for Nursing Home Medicaid, which means planning needs to begin even earlier. The lookback period for Community Medicaid is changing frequently and has a proposed lookback period of 2.5 years. Medicaid planning attorneys at Sheryll Law, P.C. can guide Long Island residents toward an effective strategy several years before an upcoming Medicaid application date and help navigate these complicated lookback periods.

NY Medicaid Application Preparation and Appeals for Denied Applications

After preparing for more than five years to qualify for Medicaid benefits, the last thing an applicant wants is to be denied. Fortunately, our team at Sheryll Law, P.C. can prepare the Medicaid application to avoid an unwanted change in plans and significant financial issues that can come with a Medicaid denial. Avoid disappointment by working closely with a New York Medicaid planning attorney while completing the application.

Our experienced Medicaid attorneys can also assess a denial to formulate an appeal strategy. Contact Sheryll Law, P.C immediately to discuss the steps to appeal following a denied Medicaid application.

Maintaining & Using Medicaid in New York

A Medicaid attorney addresses questions and coordinates to maintain continuous coverage. Recipients or their loved ones may wonder whether Medicaid covers a given health service, and changes in living arrangements can also have implications for ongoing strategies and planning.

Once a Long Island resident has qualified for Medicaid, additional responsibilities and questions arise. This process can involve a mailed packet and recertification steps with documentation requirements and deadlines. There is the risk of a coverage gap, and Medicaid mail cannot be forwarded.

A Medicaid recipient must report every move to a new residence, and adjustments may need to be made through a Local Department of Social Services (LDSS) in a given county. Not all counties have the same managed care plans. A Medicaid recipient may need to choose a new plan when moving across New York county lines.

Plan for Medicaid With The Help of a Long Island Medicaid Lawyer

At Sheryll Law, P.C., we want our clients to enjoy the benefits of a meaningful and fruitful life, and we help them plan and follow through to meet their goals in coordination with their loved ones. Remember: Proper Medicaid planning in New York takes over five years.

Call Sheryll Law, P.C. at (631) 506-8440 today or fill out our online form to schedule a strategy session and start an elder law Medicaid plan now, even if it seems early — avoid the heartache and frustration of planning late. Plan Life on Paper, Live Life by Heart

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The information in this blog post (“post”) is provided for general informational purposes only and may not reflect the current law in your jurisdiction. No information in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting based on any information included in or accessible through this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country, or other appropriate licensing jurisdiction.

Sheryll Law, P.C.
633 East Main Street, Suite 2
Riverhead, New York 11901
(631) 506-8440