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How Medicaid planning in New York is about to change

Medicare is available for most older adults. Both those who have worked jobs and those married to working individuals for a decade or longer may qualify for Medicare later in life. Retired adults rely on Medicare to cover their basic healthcare expenses.

Some adults in New York discover after retirement that Medicare does not fully meet their need for coverage. The more support someone requires, the more likely Medicare is to fall short of fully covering their costs. New York Medicaid benefits can help close the gap between someone’s medical needs and their Medicare coverage.

Older adults who require long-term care often turn to Medicaid. Previously, New York has not imposed a lookback period when reviewing applications for in-home nursing support. However, that policy is set to change in the near future. People preparing for retirement or thinking about long-term care needs may need to adjust their plans to reflect changing New York policies accordingly.

In-home care now requires advance planning

As of early 2025, applicants seeking Medicaid for long-term care needs may have to worry about their recent financial transactions. The state may look closely at any transfers in recent months when determining if the applicant is eligible for coverage and if they are subject to any penalties.

Some degree of advance planning has always been necessary, as there is a five-year or 60-month lookback period in New York for nursing home care that has existed for years. However, those seeking in-home support from nursing professionals previously benefited from more lenient rules. Their applications weren’t subject to an extensive review of prior transfers.

Lawmakers have since acted to close that loophole by implementing a new lookback period that applies to in-home care benefits. Applicants typically need to plan at least 30 months or two-and-a-half years before applying for Medicaid. Otherwise, any gifts or transfers that they make could lead to a penalty.

Medicaid planning is often a crucial aspect of elder law planning. People generally need to make major financial moves years before they think they may need benefits. Ultimately, those who understand the rules that apply to long-term care plans in New York can more effectively protect themselves and their family members from major future medical expenses.

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