There is a very good chance that you or your spouse will need some type of long-term care services during your retirement years. If either of you needs nursing home care, the cost of that care will be high. Unless you can easily afford to cover those costs out-of-pocket, you may find yourself turning to Medicaid for help. With that in mind, the Long Island attorneys at Eghrari Law Firm explain how to apply for Medicaid as a senior in New York.
Will You Need Long-Term Care?
At the age of 65, you already stand about a 70 percent chance of eventually needing some type of long-term care (LTC) services before the end of your life. If you are married or have a partner, they stand the same chance. Of those seniors who do need LTC, about 35 percent will need nursing home care. With an annual average cost exceeding $150,000 (as of 2023) in New York, nursing home care can quickly drain your retirement nest egg which is why you should plan ahead to ensure that you qualify for Medicaid if you need LTC.
Why Might I Need Medicaid as a Senior?
Prior to retirement, you may have relied on employer sponsored or privately purchased medical insurance. When you entered your retirement years, you likely became eligible for Medicare which covers most of your health care expenses. Unfortunately, Medicare does not cover long-term care costs unless they follow a hospital stay, and even then, only for a brief period. Consequently, it is wise to have a plan in place that covers LTC expenses. Even if you retained your private health insurance, that too likely excludes LTC expenses. You can purchase a separate LTC insurance policy; however, the premiums can be costly as well. For over half of all seniors, Medicaid is the only viable solution.
Applying for Medicaid for Seniors in New York
Applying for senior Medicaid benefits in New York is not particularly difficult. For most seniors, the challenging part is the approval process which includes an income and asset test. To apply for Medicaid in New York, you can navigate to the NY State of Health website and begin the process online or you can locate someone to assist you by navigating to the appropriate website and conducting a search for an “assistor.” If you have questions, you can call the Medicaid Helpline at (800) 541-2831 or visit your local Department of Social Services Office. Once you complete the application, including the submission of any documentary evidence requested to support your application, you should receive a response within four to five weeks. If you are approved, your benefits will be retroactive to the date you applied and can even cover expenses incurred prior to your application date.
Will You Qualify for Medicaid for Seniors in New York?
Medicaid is intended to help low-income families, pregnant women, children, the disabled and the aged with healthcare costs. Because Medicaid is a “needs based” program, you must demonstrate a financial need for benefits. This means that an applicant’s income and assets cannot exceed the program limits. If your assets do exceed the program limit, Medicaid will deny your application and you will need to “spend-down” your assets before applying again. The other Medicaid rule you must also be aware of when applying for Medicaid is the five-year look-back rule that allows Medicaid to review an applicant’s finances for the five-year period prior to applying for benefits. Any asset transfers made during that period for less than fair market value will likely trigger a waiting period during which time the applicant will not be eligible for Medicaid benefits.
As of 2023, the New York Medicaid income limit for nursing home Medicaid is $1,677 for an individual applicant and the asset limit is $30,182. If both spouses are applying, the income limit is $2,268 and the asset limit increases to $40,821. If you are married, but your spouse is not applying, the Medicaid “Spousal Impoverishment Rules” come into play. The rules are intended to ensure that a spouse who remains in the community is not impoverished when his/her spouse enters a nursing home. The “Community Spouse” is allowed to keep a certain amount of income and resources when the other spouse enters a long-term care facility. For example, the asset limit for a community spouse is $148,620. To ensure that your assets are protected and that you qualify for benefits when you need them, talk to your estate planning attorney about incorporating a Medicaid planning component into your estate plan.
Do You Have Questions about New York Medicaid?
For more information, please join us for a FREE estate planning seminar. If you have additional questions about Medicaid for seniors in New York, contact the Long Island estate planning attorneys at Eghrari Law Firm by calling us at 631-265-0599 to schedule your appointment.
Elder Abuse: What Is It and How Do I Spot the Signs?
See Larger Map
Get Directions