New York’s Medicaid rules require you to have limited assets before the state will pay for nursing home care, but legal tools like a Medicaid Asset Protection Trust can protect your assets from nursing home costs if you act early enough. How much you can protect depends on your assets, your family situation, and how far in advance you plan. Seligson Law helps New Yorkers put the right structures in place before a health crisis forces their hand.
If you or a loved one may need nursing home care in New York, your savings, your home, and everything you have built over a lifetime could be at risk. Nursing home costs currently run between $15,000 and $20,000 per month, and neither Medicare nor standard health insurance covers long-term custodial care.
The good news is that legal tools exist to protect what you have built, but they only work if you act before a crisis hits. Below, the estate planning attorneys at Seligson Law explain how New York’s Medicaid rules work and what steps you can take now to protect your home and savings.
Why Nursing Home Costs Threaten Your Assets in New York
Medicaid covers long-term nursing home care, but qualifying is not straightforward. For 2026, a single applicant for nursing home Medicaid in New York generally cannot have more than $33,038 in countable assets.
If you own a home, savings, or investments above that threshold, the state expects you to spend those down on your own care first. Retirement accounts are treated differently and may not be counted as a resource depending on how they are structured. Proactive legal planning is how most New York families avoid that outcome.
The Medicaid Look-Back Rule
Before you do anything with your assets, you need to understand New York’s Medicaid look-back rule. When you apply for nursing home Medicaid, the state looks back five years and reviews every asset transfer you made. This is called the 60-month look-back period, and it is written into Social Services Law Section 366.
If Medicaid finds that you gave away assets or transferred them for less than fair market value during that window, it will impose a penalty period during which it will not pay for your care. The penalty period has no set maximum and is calculated by dividing the total value of the transferred assets by the average monthly cost of nursing home care in your region.
In New York City, the official 2026 regional rate set by the New York State Department of Health is $15,282 per month, which means a $150,000 transfer, for example, could result in nearly ten months of ineligibility.
The home care look-back is changing
New York passed a 30-month look-back period for Community Medicaid into law in 2020, but as of 2026 it has not been enforced. No official implementation date has been announced. That means you can currently transfer assets and still qualify for home care Medicaid without a penalty period.
However, this window will not stay open indefinitely. When enforcement begins, any transfers made in the 30 months before your application date will be reviewed. If you anticipate needing home care services, now is the time to act.
Legal Strategies to Protect Your Assets
There is no one-size-fits-all approach to Medicaid planning. The right strategy depends on your age, health, family situation, and the types of assets you own. Here are the most widely used tools under New York law.
Medicaid Asset Protection Trust (MAPT)
A Medicaid Asset Protection Trust is an irrevocable trust specifically designed to remove assets from your name so they are not counted by Medicaid when determining your eligibility. Here is how it works:
- You transfer assets such as your home or savings into the trust
- You give up direct ownership, but you can continue to live in your home and receive income generated by trust assets
- A trustee, typically an adult child or other trusted person, manages the trust on your behalf
- Assets in the trust are not counted by Medicaid after the applicable look-back period has passed
- After your death, trust assets pass to your beneficiaries and are protected from Medicaid estate recovery
Because the MAPT is irrevocable, assets transferred into it are subject to the five-year look-back period for nursing home Medicaid. The trust must be funded at least five years before you apply for nursing home benefits for those assets to be fully protected.
Irrevocable trusts and the look-back clock
The most important planning principle in this entire post is this: the five-year clock only starts running when assets are transferred. Every day you delay is a day your assets remain exposed. Families who plan five or more years before a health crisis can protect their home and savings entirely. Families who wait until a crisis is underway have far fewer options.
Spousal protections
If you are married, New York law protects the spouse who remains at home, known as the community spouse. For 2026, those protections include:
- Up to $162,660 in countable assets the community spouse may keep
- The family home, regardless of value up to the equity limit
- One vehicle
- A monthly income allowance of up to $4,066.50 per month to prevent spousal impoverishment
These protections exist to prevent the healthy spouse from being left with nothing, but they still require careful planning to maximize.
How New York Law Governs Medicaid Planning
Medicaid planning in New York is governed primarily by Social Services Law Section 366, which establishes eligibility rules, asset limits, and the look-back framework. The New York State Department of Health administers the program and publishes annual updates to income and asset limits each year.
Because New York’s Medicaid rules are significantly more complex than most states, working with an attorney who understands both the law and how local Medicaid offices operate across New York City and the surrounding counties can make a meaningful difference in your outcome.
Talk to a New York Estate Planning Lawyer at Seligson Law
Nursing home costs in New York can wipe out a lifetime of savings in a matter of years. But with the right plan in place, you can protect your home, your assets, and your family’s financial future.
Seligson Law handles estate planning and asset protection for individuals, couples, and families across New York, including Manhattan, Brooklyn, and Queens. Call 213-293-6692 or send us a message to set up a consultation today.
Frequently Asked Questions: Protecting Assets from Nursing Home Costs in New York
1. Does New York have an asset limit for Medicaid nursing home coverage?
Yes. For 2026, a single applicant for nursing home Medicaid in New York generally cannot have more than $33,038 in countable assets. If your assets exceed that limit, you will be expected to spend down before Medicaid steps in. With proper planning, however, you may be able to protect a significant portion of your assets legally before you reach that point.
2. What is the Medicaid look-back period in New York?
New York applies a 60-month, or five-year, look-back period for nursing home Medicaid. When you apply, Medicaid reviews all asset transfers made in the five years before your application date. Transfers made during that window for less than fair market value can trigger a penalty period during which Medicaid will not pay for your care. This is why planning must begin years before you anticipate needing care.
3. Can I protect my home from nursing home costs in New York?
Yes, in many cases. Your primary home is generally not counted as a Medicaid resource while you are alive and living in it or intend to return. However, after your death, New York may pursue estate recovery to reclaim what it spent on your care. Transferring your home into a Medicaid Asset Protection Trust more than five years before applying for nursing home Medicaid can shield it from both spend-down requirements and estate recovery.
4. What is a Medicaid Asset Protection Trust?
A Medicaid Asset Protection Trust, or MAPT, is an irrevocable trust that removes assets from your name so Medicaid does not count them when determining your eligibility. You give up direct ownership of the assets, but you can continue living in your home and receiving income from trust assets. Because the trust is irrevocable and subject to the five-year look-back period, it must be created well in advance of any need for care.
5. Does Medicare cover nursing home care in New York?
Not for long-term care. Medicare may cover short-term skilled nursing care following a qualifying hospital stay, but it does not pay for ongoing custodial nursing home care. Once Medicare coverage ends, typically after 100 days at most, you are responsible for the full cost. In New York, that can be $15,000 to $20,000 per month or more.
6. What happens to my spouse’s assets if I go into a nursing home?
New York law protects the spouse who stays at home, known as the community spouse, from being left with nothing. For 2026, the community spouse may keep up to $162,660 in countable assets, the family home, one vehicle, and a monthly income allowance. However, assets above that threshold may still need to be spent down or protected through planning. An attorney can help you structure your assets to maximize protection for both spouses.
7. How early should I start Medicaid planning in New York?
As early as possible, and ideally at least five years before you anticipate needing nursing home care. The five-year look-back period means that asset protection strategies like a MAPT only work if they are put in place well in advance. Waiting until a health crisis occurs leaves you with far fewer options. Contact Seligson Law to start planning today.
