The Medicaid Look-back Period and Income
New York enforces a five-year look-back period for individuals applying for Medicaid coverage for nursing home care. This means that Medicaid officials will review all financial transactions made within the past five years to identify any asset transfers or gifts that may affect eligibility. If any such transfers are discovered, a penalty period may be imposed, delaying access to benefits. Currently, the look-back period for Community Medicaid in New York is only three months, but it is scheduled to increase to 30 months. Any assets transferred or given away during this period may be counted toward your estate and subject to scrutiny.
To protect your assets while remaining eligible for Medicaid, careful estate planning is essential. Attorney Seth Schlessel, a knowledgeable Medicaid and elder law attorney based on Long Island, can help you prepare for the look-back review. He can advise you on the timing and structure of asset transfers and guide you in developing a long-term care plan that safeguards your financial well-being.
With years of experience in estate planning and Medicaid eligibility rules, Seth Schlessel can assess your unique situation and recommend strategies such as irrevocable trusts or spousal transfers to help preserve your assets. At Schlessel Law, PLLC, we offer comprehensive Medicaid planning services aimed at minimizing financial exposure while securing essential care services.
It’s important to note that while some exceptions to the look-back penalties exist, they can be complex and require legal insight to navigate successfully. Whether you’re planning ahead or already facing eligibility issues due to past asset transfers, Seth Schlessel and the Long Island-based team at Schlessel Law can help you make informed decisions and avoid costly penalties.
Irrevocable trusts
+Establishing an irrevocable trust is a common strategy in Medicaid planning. By placing your assets into this type of trust, you remove them from your name and transfer control to a designated trustee. Once the trust is created and funded, you no longer legally own the assets or have the authority to amend the trust’s terms. This includes forfeiting the right to any income the assets may produce.
While this loss of control may seem significant, the benefit lies in the protection the trust offers. Assets held in an irrevocable trust are generally shielded from being counted toward Medicaid eligibility limits. Additionally, they are typically protected from creditors, legal judgments, or government recovery efforts, such as Medicaid estate recovery after death. This makes irrevocable trusts a valuable tool for preserving wealth while planning for long-term care needs.
Medicaid Asset Trust
+A Medicaid Asset Protection Trust is a specific kind of irrevocable trust designed to help individuals preserve their assets while still qualifying for Medicaid to cover long-term care expenses, such as nursing home or home health care. These trusts serve as a strategic tool in estate and Medicaid planning, allowing individuals to retain some benefits from their assets without having them count against Medicaid eligibility limits.
That said, trusts are not universally appropriate. Each person’s financial situation and care needs are different. Before moving forward, it’s essential to consult with a knowledgeable attorney. An experienced Long Island Medicaid planning attorney can evaluate your circumstances and help determine whether a Medicaid Asset Protection Trust is the right fit. At Schlessel Law, we regularly assist clients across Long Island with establishing irrevocable trusts as part of a comprehensive asset protection strategy. By planning early, you can safeguard your assets from Medicaid’s five-year look-back period and avoid unnecessary financial hardship.
Pooled Supplemental Needs Trust
+A pooled supplemental needs trust (SNT) is a type of irrevocable trust designed to help individuals with disabilities preserve their eligibility for means-tested government benefits like Medicaid, even if they receive funds that would otherwise disqualify them. By placing excess assets into a pooled SNT, individuals can spend down resources while still using those funds for needs not covered by Medicaid or other programs.
This type of trust is especially useful for New Yorkers with a disability as defined under the Social Security Act. It offers a way to maintain Medicaid coverage without violating asset limits or triggering penalties under the Medicaid look-back rules.
Planning ahead for a loved one with a disability can feel overwhelming, especially when navigating complex government benefit systems. An experienced Long Island Medicaid planning attorney can help determine whether a pooled SNT is appropriate for your situation. Attorney Seth Schlessel has the knowledge and experience to guide families through the process and help structure a trust that provides support while preserving vital benefits.
Common Reasons Why Medicaid Denies Applications in New York
+Medicaid eligibility is governed by strict requirements, including factors such as age, disability status, and monthly income. If an applicant does not meet all criteria, they may face delays, reductions, or outright denial of their benefits.
In New York, some of the most common reasons applicants are denied Medicaid include:
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Missing important deadlines: Gathering necessary documentation from physicians, banks, and legal advisors is essential. However, overlooking submission deadlines can jeopardize your application. These time constraints are easy to miss without careful planning and guidance.
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Income above Medicaid limits: In high-cost areas like New York, exceeding income thresholds is a common issue. Fortunately, the Medicaid Spend-Down Program allows eligible applicants to deduct certain medical expenses from their income, helping them meet qualification guidelines.
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Timing issues: Filing your application too early or too late can impact benefits. For example, Medicaid may provide retroactive coverage for up to 90 days, but a late application could leave you financially responsible for care already received. An experienced attorney can help you time your filing strategically.
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Poor asset management: Giving away property or funds in an attempt to meet Medicaid’s asset limits can backfire. New York applies a five-year look-back period, and improper asset transfers may trigger a penalty. However, legal tools such as trusts may offer viable alternatives for asset protection.
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Incomplete or missing paperwork: Any missing information or forms during the initial application process may lead to rejection. Additionally, when more documentation is requested, failure to respond thoroughly and on time can result in denial. An attorney can help ensure everything is properly submitted and documented, sometimes even using certified mail to prove compliance.
At Schlessel Law, PLLC, Nassau County Medicaid planning attorney Seth Schlessel, along with our team of Long Island estate planning lawyers, may be able to help you prepare for your family’s future with clarity and confidence. Contact us today to schedule your consultation.
