Elder Law in Queens: Medicaid & Long-Term Care

This is where families get into real difficulty, and where general advice goes wrong. Medicaid looks back at transfers of assets made before a person applies, and transfers made for the purpose of qualifying can result in a denial of coverage or a penalty period — you pay privately for care during the penalty. How far back the review reaches, what counts as a transfer, and what the penalty is depend on the circumstances and the rules in force at the time. Exempted assets, including certain trusts and the treatment of a home, complicate it further. What I will not do is promise a strategy that avoids a penalty, because anyone who does is guessing at something fact-specific and agency-dependent. What I can do is understand what you have done, explain where you stand, and plan forward.

Often there is room to work with, and often people have given up a home unnecessarily because they assumed nothing could be done. A principal residence is treated differently from other assets under New York rules, and there are exemptions and protections that can apply — depending on who lives there, whether a spouse is in the home, and whether there is other countable property. The fact that these protections exist does not mean you can rely on them without checking your particular position first. This is a conversation worth having well before care is needed, when there are still choices to make.

No. Most of the people who benefit most from elder law advice are in their fifties and sixties, planning for a parent rather than for themselves. The reason is simply that the useful decisions have to be made before there is a crisis: who will be the agent on your power of attorney, how a house is titled, whether a spouse will need income. By the time long-term care is imminent, many of the better options are already closed. Planning is also cheaper and calmer than reacting, which matters when a family is already under strain.

They need to be considered together, because a document that made sense when you wrote it can undermine your long-term care plan. This happens more often than people expect. A trust with broad language may be treated differently from what you intended. A power of attorney may be drafted in a way that does not account for the management a future home-health situation would require. A will may name an executor who cannot manage a property. The practical advice is to review the estate plan and the long-term care plan together, not separately, and to revisit both whenever your health, your family, or your property changes.