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Medicaid Eligibility For Nursing Home Care

In order to qualify for Medicaid, your life savings cannot be greater than the Medicaid resource limit. Certain assets are not counted as being part of your life savings. For example, if you have a spouse living in the family home, then the home does not count for Medicaid resource limit purposes.

If your life savings is higher than the Medicaid limit, you will not be eligible to receive Medicaid coverage for your nursing home or home care costs. You will be told to spend your life savings towards your cost of care until you are down to the Medicaid levels.

You should never assume that it is too late. Quite often you have legal options to save some or all of your life savings even if you are already in a nursing home. The Koldin Law Center, P.C. Medicaid Law Attorneys can represent you throughout the entire Medicaid process. There is something you can do.

There are many special exceptions to the basic Medicaid rules where additional assets can be protected.

Single Person Eligibility Rules in New York State

The Medicaid resource limit for a single person in New York State for 2024 is $31,175. You will be forced to sell your investments, cash in your CD’s, cash in your life insurance policies, sell your summer cottage, and sometimes even sell your home.

If you are in a Nursing Home, you will only be entitled to keep $50 of your monthly income. If you are receiving home care, you will be entitled to keep $1,752 of your monthly income (2024 figures).

Married Couple Eligibility Rules in New York State

The assets of both spouses are treated as being available to the spouse who is applying for Medicaid.

The ill spouse is treated as a single person and is entitled to keep the same income and resources as a single person.

The healthy spouse is entitled to keep a minimum spousal allowance of $74,820 up to a maximum of $154,140 of the couple’s combined life savings. The healthy spouse is also entitled to keep at least $3,853.50 of the couple’s combined income. If the healthy spouse has income of his/her own above $3,853.50, then the Medicaid Agency will “request” a contribution of 25% of all income above $3,853.50.

There are specific rules for Medicaid Covered Home Care

Medicaid Transfer Rules

As a general rule, you cannot transfer assets for the purpose of qualifying for Medicaid for Nursing Home Coverage. However, there are many exceptions to this rule. These exceptions can be important for preserving your life savings in a time of immediate crisis.

The transfer of assets can result in a penalty period of ineligibility for Medicaid coverage.

The Medicaid Agency is entitled to look at all your financial transactions for the 60 months immediately preceding your Medicaid application. Medicaid can review your bank statements and question each of your deposits and withdrawals for the past 5 years.

In the event you apply for Medicaid before the expiration of the 60 month penalty period, the government has a formula that could extend your period of ineligibility beyond the 60 month period.

If you decide to make transfers, you should then review whether it would be better to make gifts to other people or to an Irrevocable Trust. As part of making gifts, you may also want to consider transferring your home with a retained life Estate.

Retirement Accounts in New York State

If Retirement Accounts are in monthly “payout status” they are treated as “income” rather than life savings and do not need to be cashed in and spent before you are eligible for Medicaid.

When your Retirement Account is in monthly payout status, the Medicaid Agency will treat your Retirement Account as monthly income subject to the income contribution rules, rather than as part of your life savings.

Periodic payout status means that you are receiving regular periodic payments from your Retirement Account based on life expectancy tables. Some county Medicaid Agencies require Retirement Accounts to be paid out based on the IRS payout tables. Some county Medicaid Agencies require Retirement Accounts to be paid out based on Medicaid’s own life expectancy tables, which are much shorter. Other counties use one table for the applicant and a different table for the at-home spouse.

If you live longer than your life expectancy under the required payout table, your Retirement Account could become fully depleted by the monthly payments being contributed toward your cost of care.

If your at-home spouse is receiving a monthly Retirement Account payout, he/she may or may not be required to contribute towards your cost of care depending on the total family income.

One of the decisions that the family must make when you or your spouse is in a Nursing Home is whether to cash in either or both of your Retirement Accounts and then use other asset preservation methods which are discussed on our website which you can review by clicking here.

If your Retirement Account is put into payout status, it will be subject to the income contribution rules which are discussed on our website Click here.

At the Koldin Law Center, P.C. located in East Syracuse, New York, we have over 50 years of experience helping elderly individuals plan for immediate crisis and long term care. Our firm represents clients in Onondaga county and throughout all of Upstate New York.

Contact our experienced Upstate New York elder law attorneys to schedule a free initial consultation. We are available for home and hospital visits and our flat fees are very reasonable.

Practice Areas

Basic Estate Planning

Trust Planning

Medicaid Planning And MedicaidApplications

Planning For Individuals With Disabilities

Probate And EstateAdministration