You have worked hard your entire life to build a nest egg, pay off your mortgage, and have something to pass on to your children. Whether you own a home in the Bronx or have savings in Westchester, these assets represent a lifetime of work and security for your family. Then comes the devastating reality: the staggering cost of long-term care in New York, which can exceed $15,000 to $20,000 per month.

Many families think they must pay care costs until their savings are gone or they lose their home.

Estate planning lawyers in New York can tell you with authority and confidence that this is not the case. You do not have to spend down your life savings. With proactive and assertive legal planning, you can protect your assets while still qualifying for the care you need. This is the power of Medicaid planning.

What Is Medicaid and Why Is Planning So Critical?

First, it’s essential to clarify a common misconception. Medicare (which you receive at age 65) does not cover long-term custodial care in a nursing home. It only covers short-term rehab stays. The program that pays for long-term care is Medicaid, a joint federal and state program.

But Medicaid is “means-tested.” To qualify, you must have minimal assets and income. For 2025, New York has increased these limits, but they are still low enough that most homeowners and savers do not meet the qualification.

The tragedy is that many people spend their life savings on care, draining their estate in just a few years, until they are finally poor enough to qualify for Medicaid. This is not a strategy; it is a default. Proactive planning, by contrast, involves legally and ethically restructuring your assets before you need care, so you can qualify without losing everything you have worked for.

The Most Important Rule: The Medicaid Look-Back Period

To prevent people from simply giving away all their assets the day before entering a nursing home, Medicaid imposes a “lookback period.”

For Chronic Medicaid (which pays for nursing homes), this period in New York is 60 months (5 years). This means Medicaid will review all of your financial transactions for the five years preceding your application. If you gave away assets or sold them for less than fair market value during that time, Medicaid will impose a “penalty period”—a length of time when you are ineligible for benefits. This is a devastating trap: you no longer have the money to pay for care, and Medicaid will not pay for it either.

It is also critical to know that New York is phasing in a 30-month (2.5-year) look-back period for Community Medicaid (which pays for home care). This evolving rule makes planning more complex and more urgent.

The Key Strategy: The Medicaid Asset Protection Trust (MAPT)

So, how do you protect your assets from this look-back period? The single most powerful tool for this purpose is an Irrevocable Trust, commonly known as a Medicaid Asset Protection Trust (MAPT).

This is not a simple revocable living trust. A MAPT is an irrevocable trust that you create to hold your most important assets, such as your home.

  • You transfer ownership of the asset (like your house deed) to the trust.
  • You still have control in many ways. You can continue to live in the home, you can name the trustee (often a trusted child), and you can be the recipient of any income the trust generates (like dividends).
  • The transfer starts the clock. The day your home is transferred into the MAPT, the 5-year look-back clock begins to run. After 60 months, that asset is no longer “countable” and is fully protected from your long-term care costs.

Protecting Your Home: The Most Common Goal

For most families in the Bronx and Westchester County, the primary goal is protecting the family home. Many people believe their home is automatically protected. This is a dangerous myth.

While your home is often an “exempt” asset while you are alive (meaning Medicaid will not force you to sell it to qualify for care), that is not the end of the story. After you pass away, New York’s Medicaid Estate Recovery program will come to collect. They will place a lien on your home and force its sale to reimburse the state for every dollar they spent on your care.

The MAPT is the only reliable way to protect your home from estate recovery. By placing it in the trust and waiting out the 5year look-back period, you ensure that when you pass away, the home passes directly to your children or other beneficiaries, free and clear of Medicaid liens.

Proactive Planning vs. Crisis Planning

There are two main times to engage in Medicaid planning. We assertively recommend the first.

  • Proactive Planning (The 5-Year Plan): This is for people who are currently healthy and planning for the future. You work with estate planning lawyers in New York to create a MAPT, transfer assets, and start the 5-year clock. This is the most effective way to protect 100% of the assets in the trust.
  • Crisis Planning (Needing Care Now): We often have clients come to us when a spouse or parent is already in a nursing home or requires immediate care. Do not despair; it is not too late. Even in a crisis, our firm can use advanced, assertive strategies to protect a significant portion (often 50% or more) of your assets. This is a complex situation that requires immediate action, but you still have options.

Confidence and Character for a Serious Situation

This is a serious situation for your family’s financial future. You have worked too hard to see your legacy erased by medical costs. Do not wait until you are in a crisis. However, navigating New York’s Medicaid rules is not something you should attempt alone, as the system is complex, the applications are confusing, and the government agencies are intimidating.

At The Law Offices of Thomas J. Lavin, we bring confidence and character to your case. We are an experienced firm that understands the high-stakes nature of asset protection. We approach this challenge with the empathy you deserve and the assertive strategies your life savings demand. We are trustworthy advocates who will guide you, protect your legacy, and fight for your family’s security.

Call us today at (718) 957-8695 for a FREE consultation. Let our team provide an authoritative, trustworthy, and empathetic review of your situation, showing you how to protect your home and your savings.