Paying for long-term care can quickly impact your net worth, especially when yearly nursing home costs can reach into six figures. Many people assume they must spend their life savings before qualifying for financial assistance. Yet careful planning using several strategies can reduce, or even eliminate, out-of-pocket costs for nursing home care through Medicaid. Understanding how to pay for nursing home care in Long Island starts with learning how Medicaid works and how early planning can protect your assets.
At the Law Office of Andrew M. Lamkin, P.C., we help individuals and loved ones plan for long-term care while protecting what matters most. Our firm focuses on elder law and Medicaid planning in New York. We can guide you through eligibility rules and asset protection strategies, helping you move forward with your planning.
What Are Typical Nursing Home Costs on Long Island?
Nursing homes provide 24-hour medical supervision and assist with daily activities such as eating, bathing, and dressing. With nursing home costs on Long Island among the highest in the country, averaging around $180,000 per year, comparing home care vs. nursing home payment options early can help you plan for potential expenses later.
What Medicaid Planning and Long-Term Care Options Exist in NY?
Medicaid offers long-term care coverage for individuals and married couples of limited means. As an umbrella term, long-term care covers:
- Home care services—care providers assist you at home;
- Assisted living facilities—residential settings offer help with daily activities but limited medical care; and
- Nursing homes—facilities deliver 24-hour medical care and supervision.
Through Medicaid planning, Long Island long-term care options in NY may not break the bank.
How to Pay for Nursing Home Care on Long Island
People often pay for nursing home care through:
- Private funds—personal savings, retirement accounts, or investments to cover costs directly;
- Long-term care insurance—policies that pay for certain types of care; and
- Medicaid—can cover ongoing nursing home care.
Medicaid plays the most important role in long-term care planning because it can cover the full cost of nursing home care.
How Does Medicaid Eligibility for Nursing Home Care Work?
In New York, long-term care Medicaid coverage can pay for nursing home care, including room, meals, and medical services. Nursing home Medicaid eligibility in NY depends on whether you meet financial limitations and need a nursing home level of care.
Level of Care
To qualify for a nursing home, you must show that you need a nursing home level of care. This means you require ongoing assistance with daily activities such as cooking, bathing, or dressing, or need regular medical supervision.
Resource and Income Limits
You can only qualify for Medicaid if you have a limited income and own limited assets. In 2026, you can earn up to $1,836 and own up to $33,038 while qualifying for Medicaid. If only one spouse in a married couple applies, the other spouse can remain in the home and retain up to $162,660 in assets.
Not every asset counts against your resource limit, however. Only “countable” assets do.
Countable vs. Non-Countable Assets
When Medicaid determines whether you meet its resource limitations, it adds together your countable assets and compares that sum to the Medicaid resource cutoff. Countable assets include resources Medicaid expects you to use toward your care before it steps in, such as bank, retirement, and investment accounts.
Non-countable assets include resources that Medicaid does not count for eligibility purposes, which may include:
- Your primary residence (within equity limits),
- Personal belongings, and
- Prepaid burial arrangements.
For nursing home care, the program considers what countable assets you own when you apply and any you owned during a lookback period.
The Lookback Period
When you apply for coverage, Medicaid reviews your financial activity from the five years before you apply—the lookback period. If you gave away assets or sold them for less than fair market value during this time, Medicaid considers them as part of your countable assets at the time you apply for coverage.
If the value of those assets pushes your countable assets above Medicaid’s cutoff, the government imposes a penalty period. During that period, Medicaid will not pay for your care.
Strategies to Help Pay for Nursing Home Care
Medicaid is one of the only cost-assistance programs that helps with long-term care. As a result, many individuals use Medicaid planning to arrange income, assets, and timing so they can meet eligibility requirements without giving up more than necessary.
Irrevocable Trusts
An irrevocable trust is a special legal arrangement where you:
- Create a document establishing rules for how to treat assets that the trust owns,
- Limit your ability to control assets after you place them into the trust,
- Name a trustee to manage the trust,
- Name beneficiaries to benefit from the trust, and
- Transfer assets into the trust.
Through an irrevocable Medicaid Asset Protection Trust (MAPT), you can convert your countable assets into non-countable assets.
Asset Spend-Down Strategies
If you exceed Medicaid’s asset limits, you can reduce countable assets through approved spending and qualify for coverage once your assets are below the cutoff by:
- Paying off debts,
- Making necessary home improvements,
- Purchasing a primary vehicle, and
- Prepaying funeral and burial expenses.
Spend down strategies allow you to use your resources in ways that benefit you rather than losing them to nursing homes.
Crisis Medicaid Planning
If you or a loved one already needs nursing home care, we often call that situation crisis planning. Even during a crisis, you may be able to:
- Protect a portion of your assets,
- Reduce penalty exposure, and
- Qualify for Medicaid more quickly.
Your available strategies depend on timing, asset types, and your family’s circumstances.
Get Guidance on Paying for Long-Term Care
At the Law Office of Andrew M. Lamkin, P.C., we help Long Island families navigate Medicaid planning to protect their assets and secure coverage. We guide you through eligibility, applications, and planning strategies so you can make informed decisions at every stage.
If you are facing long-term care decisions, contact our office today.
Legal References Used to Inform This Page
To ensure the accuracy and clarity of this page, we referenced official legal and other resources during the content development process:
- New York State Partnership for Long-Term Care, Estimated Average New York State Nursing Home Rates (2026).
- American Council on Aging, New York Medicaid Eligibility for Long Term Care: Income & Asset Limits (updated March 4, 2026).
- Eligibility, N.Y. Soc. Serv. Law § 366 (2025).
- Availability of assets held in trust, 18 N.Y.C.R.R. § 360-4.5 (2025).
Andrew Lamkin is principal in the law firm of Andrew M. Lamkin, P.C., where he focuses his practice in the areas of elder law, estate planning and special needs planning, including Wills and Trusts, Medicaid planning, estate administration and residential real estate transactions. He is admitted to practice law in New York and New Jersey.
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