Protect what you spent a lifetime building
Long term care is the largest financial risk most families face in retirement. Planning ahead is what keeps it from consuming everything.
📞(518) 313-3090Call or text, I answer my own phoneThe problem, plainly
Nursing home care in New York routinely costs more than most households earn in a year. Medicare does not cover extended custodial care. Private long term care insurance is expensive and many people do not have it. That leaves Medicaid, which has strict asset limits and looks back at transfers you made before applying.
The result is that families who did nothing in advance often spend down a lifetime of savings, and sometimes the house, before help arrives. Families who planned early frequently do not.
What Medicaid planning involves
Which of these applies depends on what you own and how much time there is. Most plans use more than one.
Medicaid Asset Protection Trusts
An irrevocable trust that holds assets, commonly the family home, outside of what Medicaid counts, while allowing you to continue living there and preserving important tax treatment for your heirs. The catch is timing. These trusts must be established well before care is needed, because transfers are subject to a lookback period.
Protecting the family home
For many families the house is the largest asset and the one they most want to keep. Depending on your circumstances, the right approach may be a trust, a deed with a retained life estate, or a transfer to a protected class of family member. These are not interchangeable and the wrong one causes real damage.
Crisis planning
Sometimes there is no advance warning. A fall, a stroke, a sudden decline. Even then, options usually remain. Planning at the point of crisis protects less than planning years ahead, but the difference between acting and not acting is often substantial.
The documents that go with it
A durable power of attorney with properly drafted gifting authority is essential. Without it, no one can carry out planning on behalf of someone who has lost capacity, and the family may be forced into an Article 81 guardianship proceeding instead.
The single most important factor
Timing decides how much can be protected. Medicaid lookback rules mean that transfers made too close to an application can trigger a penalty period during which benefits are unavailable. Those rules differ between nursing home care and home care, and New York's rules in this area have changed several times in recent years.
What that means practically is simple: the best time to plan is while you are healthy and nothing is urgent. The current rules as they apply to your situation are something we go through in the consultation.
Questions families ask
Will I lose control of my house if I put it in a trust?
A properly drafted Medicaid Asset Protection Trust generally lets you continue living in the home for the rest of your life and preserves your real property tax exemptions. What you give up is the ability to sell it and keep the proceeds outright, since the trust is irrevocable. That tradeoff is exactly what we talk through before anything is signed.
Can I just give the house to my children?
You can, and it is often a mistake. An outright gift exposes the house to your children's creditors and divorces, can cost your heirs a significant capital gains tax benefit, and still counts as a transfer for Medicaid purposes. A trust usually accomplishes the goal without those consequences.
Is it too late if a parent is already in a facility?
Usually not too late to do anything, though the options narrow. Crisis planning can still protect a meaningful portion of assets in many cases. The worst outcome is doing nothing because someone assumed it was hopeless.
How does this fit with my estate plan?
It should be one plan, not two. Medicaid planning affects how assets are titled, who inherits and how they are taxed, so it needs to be drafted alongside your will, powers of attorney and beneficiary designations rather than bolted on afterward. More on estate planning →
The best time to plan is before you need to
A conversation now costs you twenty minutes. Waiting can cost considerably more.
📞(518) 313-3090Call or text, I answer my own phone