Paying for long-term medical care can quickly deplete years’ worth of savings. Nursing home costs can even put a home at risk, depending on whether you continue to live in it, someone else lives there, or you intend to return. Naturally, many people want to protect assets from nursing home costs in New York while still qualifying for financial assistance.
At the Law Office of Andrew M. Lamkin, P.C., we focus exclusively on estate planning and elder law for individuals and families throughout Long Island. We help clients understand Medicaid rules, protect their property, and prepare for long-term care. From drafting wills and trusts to handling Community and Institutional Medicaid applications, we guide you through each requirement to help you make informed decisions about your future.
How Medicaid Works for Long-Term Care in New York
Medicaid provides healthcare to individuals with limited means. However, to qualify, there are limits to how much you can own or earn in monthly income.
New York offers several types of Medicaid coverage:
- Community Medicaid—covers care at home, such as home health aides and personal care services;
- Institutional Medicaid—for care in a nursing home or skilled nursing facility; and
- Regular Medicaid—covers general medical care but usually does not include long-term custodial care.
In New York, institutional coverage includes an extra requirement that Community Medicaid does not: the lookback period. When you plan to protect a home from nursing home NY Medicaid costs, understanding what assets count against the resource limit, how the lookback period works, and what your options are if you own more than the program allows is important.
Countable vs. Non-Countable Assets
Medicaid divides what you own into countable and non-countable assets.
You add countable assets together to determine what resources you own for Medicaid cutoff purposes. Common examples of countable assets include:
- Money in checking or savings accounts;
- Investment accounts, such as stocks or bonds;
- Additional real estate that is not your primary home; and
- Certain life insurance policies.
If the total value of these assets exceeds Medicaid’s limit, you will not qualify until you reduce or restructure them.
Medicaid does count non-countable assets toward your total when determining eligibility. Examples of common non-countable assets include:
- Your primary residence, if it meets equity limits ($1,130,000 in 2026) and you intend to return home, or a relative like your spouse continues to live in the home;
- Personal belongings, such as furniture and clothing;
- One vehicle; and
- Prepaid funeral and burial arrangements.
You can keep non-countable assets even if they exceed the typical cutoff values.
The Medicaid Lookback Period
When you apply for Institutional Medicaid to cover nursing home care, Medicaid reviews your financial history from the five years immediately preceding your application. During the review, Medicaid looks for transfers where you gave away or sold assets for less than fair market value. If you did, the government adds the value of that asset to the total of the assets you currently own. As a result, you may become ineligible for coverage despite no longer owning the asset.
If your history includes such transfers, the government imposes a penalty period. During that time, Medicaid will not pay for your nursing home care even if you otherwise qualify. The length of the period depends on how far above the resource limits the asset would place you.
Medicaid Spend Down Rules
If your countable assets exceed Medicaid’s limit, you may need to follow the Medicaid spend down rules before you qualify for coverage. When you spend down assets, you use them to pay for goods or services that benefit you while reducing your pool of resources.
Costs that Medicaid may consider valid include:
- Paying off outstanding debts,
- Making repairs or improvements to your home,
- Purchasing items that Medicaid does not count, and
- Paying in advance for funeral and burial expenses.
Planning far enough in advance often allows you to avoid spending down assets.
Strategies to Protect Assets from Nursing Home Costs in New York
While Medicaid rules can be strict, certain strategies can help you protect your assets while still qualifying for benefits. Your lawyer can help you enact these strategies to comply with Medicaid requirements.
Medicaid Asset Protection Trust in NY
A Medicaid Asset Protection Trust (MAPT) is a particularly effective tool for long-term planning. To create an MAPT, you work with your lawyer to create a document establishing rules for how a trust will work. Then, you transfer ownership of assets, such as your home or savings, into the trust.
The trust must be irrevocable, meaning you cannot change or cancel it after you create it, and your control over assets within is limited. Yet, if you transfer assets into a properly structured trust before the lookback period, assets held in the trust no longer count against your resource limit.
Strategic Asset Transfers
In some situations, you may strategically transfer assets as part of a larger plan. When you structure these transfers correctly, you can transfer assets well in advance of needing care, avoiding penalties. Your lawyer can guide you through timing transfers if you use this approach as part of a coordinated plan.
Income and Asset Restructuring
Depending on what you own, you might also change how you own or categorize your assets so Medicaid does not count them. You may:
- Convert cash into non-countable assets,
- Adjust ownership of property, or
- Reorganize your finances.
Unlike spend down, which reduces assets, this strategy focuses on preserving value while still meeting Medicaid rules. How and whether you can implement it depends on what you own and how you own it.
Work with a Long Island Estate Planning Attorney Today
Effective long-term care planning in NY requires a plan that coordinates your legal and financial circumstances with your goals. At the Law Office of Andrew M. Lamkin, P.C., we can help you with your nursing home Medicaid planning, allowing you to protect assets from nursing home costs.
If you want to explore your long-term care planning options, contact our office to schedule a consultation.
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:
- 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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