New York Medicaid Planning Attorney

When you’re thinking about long-term care and how to safeguard what you’ve built, the right strategies can make a real difference in New York. Our attorneys can walk you through specific approaches that can help you manage your assets in line with state rules and plan ahead with confidence.

Medicaid Asset Protection Trusts (MAPTs)

The Medicaid Asset Protection Trust (MAPT) is a type of irrevocable trust designed to keep certain assets from being counted toward Medicaid eligibility, as long as it’s set up and funded correctly. In a MAPT, you transfer ownership of selected assets to the trust so they are no longer legally in your name. A third party, often an adult child or other trusted relative, serves as trustee and manages those assets under the terms of the trust.

To be effective, the trust must follow strict rules: you cannot continue to treat the assets as if they were still yours, and the timing of transfers must be planned carefully to avoid issues with Medicaid’s lookback period.

Because of these timing rules, a MAPT typically won’t help if you already need Medicaid or expect to apply in the very near future. However, if you’re planning ahead to preserve assets while also preparing for possible long-term care needs, a well-structured and properly timed MAPT can be a strong strategy.

Strategic Gifting and Spend-Down Techniques

Another path is to reduce countable assets through lawful gifting or planned expenditures (“spend-down”) so that you meet eligibility thresholds for Medicaid in New York.

• Gifts to family or others can reduce assets, but the state will review transfers made in the period before your application (look-back period) and may impose a penalty if they find disqualifying transfers.
• Legitimate spend-down means converting countable assets into exempt assets or paying for care, home improvements, or pre-paying funeral costs, all expenditures that the rules allow.

It’s critical to document transactions, maintain records, and avoid giving away assets simply to qualify for Medicaid, as those kinds of transfers can trigger penalties. If you have countable resources over the limit, working thoughtfully with gifting or spend-down approaches can help you to meet the eligibility requirements.

Spousal Refusal in New York

In New York, one strategy available when one spouse needs long-term care is “spousal refusal.” This allows the healthy (“community”) spouse to refuse to contribute income or assets to the institutionalized spouse’s care, which may allow the applicant spouse to qualify for Medicaid sooner.

• The community spouse signs a legal document declining to contribute their income or assets toward the other spouse’s care.
• Even though spouses are legally obliged to support each other, New York law allows the refusal and still permits the institutionalized spouse to apply for Medicaid.

This option may not be the right choice for every couple, as this strategy involves risks, including potential state cost-recovery actions and complex timing. Working with an attorney is recommended to avoid issues down the line.

But when the circumstances allow, a refusal may protect the home spouse’s resources and give you a workable route to Medicaid support for the care-needing spouse.