If you’re receiving Medicaid benefits in Long Island and thinking about getting married, you may be worried about what that could mean for your coverage. The fear is understandable. Medicaid eligibility is based on income and asset limits, and marriage can change those numbers. You may rely on Medicaid for medical care, in-home care, or even nursing home services, and losing that support could affect your daily life, your finances, and your future.
Many New York families find themselves facing this same question: will I lose my Medicaid if I get married? The answer depends on several factors, including your current type of Medicaid coverage, the assets and income of your future spouse, and how your finances are structured.
In this blog, we’ll break down what marriage means for Medicaid eligibility and how proper planning may help protect the benefits you rely on.
How Marriage Affects Medicaid Eligibility in New York
In New York, Medicaid is available to people who meet strict financial eligibility requirements. When you get married, your spouse’s income and assets are counted along with your own. This combined total is what Medicaid uses to determine whether you still qualify.
Here’s where things get tricky. Even if your future spouse has modest savings or a steady income, those resources may be enough to put you over the limit. That can put your Medicaid coverage at risk unless you take steps to protect it.
Types of Medicaid that may be affected include:
- Community Medicaid, which covers in-home care and other non-institutional services
- Nursing home Medicaid, which helps pay for long-term care in a skilled nursing facility
- Medicaid home care services through a Managed Long-Term Care (MLTC) plan
Each type has slightly different income and asset rules, but all of them require financial disclosures from both spouses once you’re married.
2025 Medicaid Eligibility Limits for Long Island Residents
As of 2025, the New York State Department of Health has set the following limits for individuals applying for Medicaid long-term care:
- Monthly income limit: $1,800 for the applicant
- Asset limit (applicant): $32,396
If only one spouse is applying for Medicaid, spousal impoverishment protections allow the non-applicant spouse (community spouse) to keep additional assets under the Community Spouse Resource Allowance (CSRA), set at $157,920 for 2025. This ensures the community spouse retains assets without affecting the applicant’s eligibility.
Additionally, the Monthly Maintenance Needs Allowance (MMMNA) protects up to $3,948 per month in household income for the community spouse. If their income is below this, the applicant’s income may be diverted to meet the threshold.
These spousal impoverishment protections are designed to prevent financial hardship for the healthy spouse while enabling access to long-term care benefits. For couples with assets exceeding these limits, strategies like spousal refusal (described below) may help.
Spousal Refusal and How It Works
New York is one of the few states that allows a legal strategy known as spousal refusal. If you are applying for Medicaid and your spouse’s income or assets would disqualify you, they may submit a signed statement refusing to contribute to your care. This allows Medicaid to evaluate your eligibility based on your own income and assets, even if your spouse’s finances would normally exceed the limits, provided they sign a formal refusal of support.
Unlike spousal impoverishment protections, which let the non-applicant spouse retain a limited share of income and assets, spousal refusal excludes the community spouse’s resources entirely. This can be critical when combined resources exceed Medicaid limits but you need access to long-term care.
However, the state may seek reimbursement from the refusing spouse, though such actions are uncommon. Spousal refusal is a powerful strategy but should be used only after consulting a qualified attorney to evaluate potential financial and legal risks.
What About the Look-Back Period?
If you’re applying for nursing home Medicaid in New York, the state will look back five years (60 months) from the date of your application to see whether you’ve transferred any assets for less than fair market value. This is known as the look-back period, and any disqualifying transfers could delay your eligibility.
As of mid-2025, there is still no look-back period for Community Medicaid in New York. Although changes were proposed that would add a 30-month look-back for home care services, those changes have not been implemented as of this writing.
Notify the Department of Social Services About Your Marriage
If you are currently receiving Medicaid and get married, you are required to promptly notify your local Department of Social Services about the change in your marital status. This is important because marriage can affect your Medicaid eligibility due to combined income and assets. Failure to report this change in a timely manner could result in:
- Repayment of Medicaid benefits received after the marriage
- Potential fines or penalties
- In extreme cases, allegations of fraud
To avoid complications, contact your local Department of Social Services (e.g., Nassau or Suffolk County on Long Island) as soon as possible after your marriage to update your records and ensure compliance with New York State Medicaid regulations.
Protecting Your Medicaid Benefits with the Right Tools
If you’re planning to marry and want to protect Medicaid coverage, there are several strategies that may apply to your situation. Not every option works for every family, and the wrong move can create new problems. That’s why early planning is so important.
Some common tools used in New York Medicaid Planning include:
- Medicaid Asset Protection Trust (MAPT): This irrevocable trust allows you to transfer ownership of assets while retaining limited use. After the five-year look-back period for nursing home Medicaid, those assets are not counted for eligibility purposes.
- Life estate deeds: These allow you to retain the right to live in your primary residence while transferring future ownership to a family member or trust, protecting the home from Medicaid estate recovery.
- Income-only trusts: Used to divert excess income above Medicaid limits into a trust that pays for medical bills or care while still qualifying for Medicaid benefits.
- Spend-down strategies: Strategies such as using excess assets to pay off debts, prepay for funeral expenses, or make necessary home improvements, may also be appropriate when applied carefully.
Each of these tools must follow strict Medicaid rules to be effective.
Common Medicaid Planning Issues After Marriage
Once you’re married, you and your spouse become financially linked in the eyes of the law. This can raise several common issues that many New York families face:
- Losing eligibility for Community Medicaid or in-home care
- Being denied coverage due to your spouse’s assets
- Facing high nursing home bills that Medicaid won’t cover
- Making transfers that violate Medicaid rules and trigger penalties
- Discovering too late that a family member’s home or other assets are at risk
Medicaid law is not always intuitive, and even well-meaning financial gifts to adult children can complicate your application. It’s not just about health care; it’s about protecting what you’ve worked for and making sure your future is secure.
Early Planning Matters More Than You Think
Marriage doesn’t automatically mean you’ll lose Medicaid, but it does change the way your eligibility is calculated. If you’re receiving Medicaid now and thinking about getting married, or if your fiancé already has assets that might affect your future plans, it’s a smart move to talk with a New York Medicaid Planning attorney before saying “I do.”
Planning ahead gives you time to:
- Restructure income or asset holdings
- Create a Medicaid Asset Protection Trust
- Use legal techniques that protect family members and property
- Review whether life insurance policies, home equity, or capital gains taxes might create problems later
- Prepare for the legal process with accurate documentation
This kind of advance planning is especially important for those who may need long term care, assisted living facility placement, or Medicaid home care services in the future.
Talk to Medicaid Planning Attorneys Before You Say “I Do”
Marriage is a personal milestone, but it comes with real consequences for your Medicaid eligibility in New York. The rules, income and asset limits, and the legal process all become more complicated once you’re married. But you don’t have to choose between your relationship and your future health care.
Whether you’re currently receiving benefits or thinking about the future, Sheryll Law, P.C. can help you make informed decisions that protect your relationship and your financial stability.
Our firm works with New York families every day to address Medicaid Planning issues before they become costly mistakes. We’ll help you understand how your upcoming marriage could affect your benefits and review your options for protecting what matters most.
Call (631) 506-8440 or fill out our confidential online form to schedule your private consultation. Your search for a “Medicaid Planning attorney near me” brought you here. Take the next step with a team that understands the legal and financial landscape of Long Island Medicaid Planning.
Protect your Legacy with Sheryll Law.
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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.
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