What You Need to Know about Medicaid’s “Look-Back” Rule | Long Island Estate Planning (2024)

FAQs

What assets are exempt from Medicaid estate recovery rights in NY? ›

The good news is that some assets are completely exempt from recovery if your family goes through the probate process after you pass away. Anything that is meant to be dispersed to a named beneficiary is usually safe from Medicaid, as are: Life insurance policies. Joint owned bank accounts.

The sixty-month lookback rule, also known as the Medicaid lookback period, applies to those seeking to qualify for the Medicaid program in New York for nursing home coverage/Chronic Care Medicaid. It intends to prevent people from transferring their assets to be eligible for the program.

In New York, Medicaid can only recoup that which it has paid out from the estate of the deceased Medicaid beneficiary. Under New York law, for these particular purposes, an estate refers to the real and personal property as well as other assets of the deceased that pass under the terms of their Last Will and Testament.

A popular strategy to protect your resources and still become eligible for Medicaid long term care benefits is by establishing a Medicaid Asset Protection Trust (MAPT). When you transfer your assets in a MAPT, Medicaid will not count the money in the trust toward its resource limit.

When a person is drawing Medicaid benefits and inherits money or property, that inheritance jeopardizes the benefits. The inheritance must be handled carefully to minimize expensive penalties.

When an individual New Yorker applies for Medicaid to pay for nursing home costs, they can qualify if their available financial resources do not exceed $31,175. If they do have more resources than allowed, Medicaid will not approve benefits until they reduce their assets by spending them down.

Expenses paid by ADAP or EPIC in the 3 months before the Medicaid application is filed can be used to meet your spend-down for the first six months of Medicaid enrollment. This means Medicaid will give credit even for payments NOT made by the recipient but paid by EPIC or ADAP. These bills can be very high.

Within 72 Hours (three days) of an Inpatient Admission

The New York State (NYS) Medicaid Program policy mirrors the Centers for Medicare and Medicaid Services (CMS) policy regarding the billing of outpatient services provided within 72 hours (three days) of a hospital inpatient admission.

All pharmacy, physician, ambulatory care services and inpatient hospital services, not provided in a nursing home, are covered. Coverage for all Medicaid covered services/supplies. Coverage for medical services except inpatient care, institutional long term care, alternate level of care, and long term home health care.

What is the income limit for Medicaid in NY in 2024? ›

For 2024 the COLA is 3.2% and the income limits for “Non-MAGI” Medicaid have increased from $1,563/ month for a single person and $2,106/ month for a couple in 2023, to $1,677/ month for a single person and $2,268/ month for a couple in 2024.

Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

New York has a 60-month Medicaid Look-Back Period for Institutional (Nursing Home) Medicaid that immediately precedes one's Medicaid application date. During this period, Medicaid scrutinizes all asset transfers to ensure none were gifted or sold under fair market value. This includes transfers made by one's spouse.

Under federal law, the Medicaid program can indeed seek to attach the portion of the home that you retained ownership of after you die. For example, if your son and your daughter were joint tenants, a third of the value of the home would be fair game for the Medicaid recovery unit.

“NY emergency Medicaid planning with promissory notes” allows you to preserve half of your assets so that only one-half your assets are spent on nursing home or assisted living care. NY emergency Medicaid planning is recognized by the New York courts and by county Departments of Social Services.

Exemptions generally include one's primary home, personal belongings, household items, a vehicle, burial funds up to $1,500 or a life insurance policy with a cash value up to $1,500, and non-refundable pre-paid funeral agreements. In New York, IRAs and 401Ks in payout status are also exempt.

Assets with a named beneficiary, such as life insurance policies or retirement accounts, are also not subject to probate because the asset is already legally required to go to that beneficiary. This includes assets like trusts and retirement accounts.

How the New York Medicaid Estate Recovery Program Can Take Your Home. The New York Medicaid Estate Recovery Program may place a lien on property owned by benefit recipients at the time of their death when it is part of an estate being administered in the Surrogate's Court.

Time Limit on Medicaid Estate Recovery

The time limit or statute of limitations for Medicaid to recover costs from the estate of the Medicaid recipient is generally seven months from the time the executor or administrator is appointed by the court.