Medicaid Retroactive Coverage in New York: How Does It Work?

In New York, retroactive Medicaid can help cover certain healthcare costs from the three months before your application was approved. It’s there to offer some relief for people who applied late or ran into delays they couldn’t control. This kind of coverage can make a real difference, especially when medical bills start to feel overwhelming. If you or a loved one might qualify, it’s worth looking into sooner rather than later. Taking those first steps could mean getting back some of the money spent on hospital stays, doctor visits, or other care during that gap period.

At Schlessel Law PLLC, our experienced Long Island Medicaid planning attorney can help you understand the eligibility requirements, the application process, and the documentation needed to apply. Our team of skilled attorneys is here to guide you through the system and secure the reimbursement you deserve for past medical expenses. Don’t let financial burdens prevent you from accessing essential healthcare services. Contact us today at (516) 574-9630 to learn more about our services and to schedule a consultation.

Is Medicaid Retroactive in New York?

In New York, Medicaid coverage does not begin from the date of application or approval. It has the potential to cover medical expenses incurred up to 90 days before the application was filed. This is particularly beneficial for individuals who may have delayed their Medicaid application due to unawareness or other obstacles.

To take advantage of this retroactive coverage, applicants must meet Medicaid eligibility requirements for the period they seek coverage. This means that during the 90 days prior to the application, the applicant’s income level and other eligibility criteria must align with Medicaid’s standards.

Retroactive coverage isn’t automatic and must be requested by the applicant. This step is crucial and often overlooked. When applying, individuals must indicate their need for retroactive coverage and submit proof of medical expenses incurred during the retroactive period. Doing so can make a substantial difference, potentially eliminating or reducing unpaid medical bills that could lead to financial strain.

Eligibility for retroactive Medicaid in New York provides a financial safety net, ensuring that healthcare needs do not result in overwhelming debt. This program allows eligible individuals and families to seek medical care when needed, knowing that their coverage can extend to past periods, supporting both their health and financial stability.

Long Island Medicaid Planning Attorney – Seth Schlessel

Seth Schlessel

Seth Schlessel is the Managing Member and Founder of Schlessel Law PLLC, a Long Island-based firm focused on elder law, estate planning, and Medicaid planning. Seth works closely with individuals and families to preserve their assets, secure long-term care solutions, and handle the challenges of New York’s Medicaid eligibility rules. He brings compassion and strategic insight to every case, making sure that clients receive guidance tailored to both their financial future and personal values.

Seth graduated from Touro Law School in 2013, where he served in multiple leadership positions, including Vice President of the Sports and Entertainment Society. Since being admitted to the New York Bar in 2014, he has taken pride in handling the firm’s more complicated cases. As both an advocate and a firm leader, Seth is deeply committed to helping Long Island families protect their assets while securing the care they deserve.

Understanding Medicaid Retroactive Coverage

Retroactive Medicaid refers to the provision of healthcare benefits for medical expenses incurred before an individual’s official eligibility start date. It allows eligible individuals to receive reimbursement for costs they have already paid out of pocket. 

The process of applying for Medicaid can be complex and time-consuming, making it challenging for individuals to become immediately eligible for coverage. Moreover, when dealing with a serious illness or injury, applying for Medicaid may not be the primary concern. This is where retroactive eligibility comes into play, providing individuals with the opportunity to apply for Medicaid coverage without the immediate worry of how medical bills will be paid. 

As long as the applicant meets the eligibility criteria for Medicaid for the three months prior to their application, Medicaid will cover the expenses incurred during that period. It is worth noting that even after an individual’s passing, a retroactive eligibility application can still be filed on their behalf. While some states may only cover unpaid medical expenses, others will reimburse Medicaid recipients for both unpaid and paid bills.

Retroactive coverage ensures that individuals have access to necessary healthcare services, even for conditions or treatments that arose during the retroactive period. This helps prevent delays in receiving timely care and supports individuals’ overall well-being. Retroactive coverage also provides a sense of security and peace of mind, knowing that medical expenses incurred during the retroactive period will be covered, promoting financial stability and health assurance for eligible individuals.

Eligibility Criteria for Retroactive Medicaid

Income Limits and Guidelines

Retroactive Medicaid in New York has specific income limits and guidelines that individuals must meet to qualify. These limits take into account the size of the household and are based on a percentage of the Federal Poverty Level (FPL). In general, the applicant must be eligible for Nursing Home Medicaid, meaning they must be eligible under the New York State guidelines for long-term Medicaid. 

To qualify for Nursing Home Medicaid in New York in 2024, an individual must satisfy specific criteria. This includes having an income below $1,732 per month and possessing assets valued at less than $31,175.

Residency Requirements

Eligibility for retroactive Medicaid coverage in New York is contingent upon meeting residency requirements. Individuals must be residents of New York State and provide documentation to prove their residency, such as utility bills or lease agreements. 

Age and Disability Criteria

Retroactive Medicaid is available to individuals who meet specific age and disability criteria. For elderly individuals, typically aged 65 or older, proof of age is required. Additionally, individuals with disabilities must provide medical documentation and meet the Social Security Administration’s criteria for disability. The applicant must also meet a functional need for Nursing Home Level of Care, meaning they must need assistance to do daily activities.

Citizenship and Immigration Status

To be eligible for retroactive Medicaid coverage in New York, individuals must be U.S. citizens, U.S. nationals, or qualified immigrants. Proof of citizenship or immigration status, such as a valid passport or green card, is required. A skilled Medicaid planning attorney can assist in verifying your status and ensuring compliance with citizenship and immigration requirements.

Meeting the eligibility criteria can be complicated. Seeking the guidance of a Medicaid planning attorney is essential to ensure that you meet all the necessary requirements and have the best chance of qualifying for retroactive coverage. An attorney can assess your income, residency, age, disability, and immigration status, providing tailored advice and assistance to help you work through the details of the eligibility process.

Can You Apply for Retroactive Medicaid After Someone Dies in NY?

In New York, it is possible to apply for retroactive Medicaid on behalf of a deceased individual. This is often done to help cover unpaid medical bills for care received during the three months before the individual’s Medicaid application date. These retroactive benefits can reduce or eliminate significant debt from the estate.

This type of application can be filed by certain people close to the deceased, including a surviving spouse, an adult child, or the executor or administrator of the estate. While filing after death is allowed, there are additional requirements. You will need to provide documentation that proves the person was eligible for Medicaid during the retroactive period, along with records of any unpaid medical expenses from that time.

Keep in mind that retroactive Medicaid only covers services that Medicaid would normally approve. It does not include transportation-related costs, such as funeral expenses.

Applying after death can be a beneficial financial step for families managing the estate of a loved one. It allows Medicaid to cover eligible services that were not previously paid for, potentially easing the financial burden during a difficult time.

It is recommended that you contact an experienced Long Island Medicaid planning attorney for guidance on the specific documentation required. The process can involve a substantial amount of paperwork, making accuracy from the start essential.

Retroactive Medicaid Coverage Period

Retroactive Medicaid in New York has a specific coverage period that determines the time frame for which individuals can receive retroactive benefits. Generally, the retroactive coverage period starts three months prior to the month of application. This means that eligible individuals may receive reimbursement for medical expenses incurred during this retroactive period. However, it is important to note that the coverage period may vary based on certain circumstances and eligibility factors. 

Effective Dates of Coverage

The effective date of Medicaid retroactive coverage is determined by the date of application and eligibility criteria met. If an individual is determined eligible for retroactive coverage, the coverage will typically begin from the start of the retroactive period. It is crucial to submit the application as soon as possible to maximize the potential coverage. 

Exceptions and Limitations

While retroactive Medicaid offers valuable benefits, there are exceptions and limitations to be aware of. Certain circumstances may impact the length of the retroactive coverage period or eligibility for retroactive benefits. For instance, changes in income, household composition, or eligibility category during the retroactive period can affect the coverage period. Additionally, there may be limitations on the types of services or expenses that qualify for retroactive coverage. Understanding these exceptions and limitations is crucial in managing expectations and making informed decisions. 

Working with a Medicaid planning attorney can ensure that your application is submitted accurately and promptly, helping to secure the earliest possible effective date of coverage. A Medicaid planning attorney can provide insights into the specific exceptions and limitations that may apply to your situation, ensuring that you have a comprehensive understanding of the coverage parameters.

Medical Services Covered by Retroactive Medicaid

Retroactive Medicaid in New York includes a wide range of medical services that are eligible for reimbursement. These services typically encompass essential healthcare needs, such as hospitalization, primary care, and specialty care accrued by the patient during the covered period. To learn more about the specific services retroactive Medicaid covers, consulting a skilled attorney is essential. Medicaid planning attorneys can provide detailed information, ensuring that you have a comprehensive understanding of the benefits available to you.

Reimbursement Process for Retroactive Medical Expenses

Once approved for Medicaid retroactive coverage, eligible individuals can seek reimbursement for medical expenses incurred during the retroactive coverage period. The reimbursement process typically involves submitting documentation of the paid medical expenses, such as receipts or invoices, along with the required claim forms. 

Documentation and Verification Requirements

To receive reimbursement for retroactive medical expenses, certain documentation and verification requirements must be met. This may include providing proof of payment, such as receipts or billing statements, as well as verifying that the expenses are related to eligible medical services. 

Handling the reimbursement process for retroactive medical expenses under Medicaid retroactive coverage requires attention to detail and adherence to documentation requirements. Working with a Medicaid planning attorney can simplify this process, as they can provide guidance on the medical services covered, assist in completing the reimbursement forms accurately, and help you compile the necessary documentation. With an attorney’s support, you can ensure a smooth reimbursement process and receive retroactive benefits for the medical expenses incurred during the eligible period.

Retroactive Coverage Limitations

While retroactive Medicaid provides valuable benefits, it is important to be aware of certain limitations. Retroactive coverage may have specific limitations, such as restrictions on the types of services covered or the duration of the retroactive period. For example, certain elective procedures or non-emergency services may not be eligible for retroactive coverage. Understanding these limitations is crucial to managing expectations and ensuring that individuals have a realistic understanding of the benefits they can receive under retroactive coverage.

Time Sensitivity and Filing Deadlines

Time sensitivity and filing deadlines are essential considerations when it comes to retroactive coverage. Medicaid applications and reimbursement claims must be submitted within specified timeframes to be considered for retroactive coverage. Failing to meet these deadlines may result in a loss of retroactive benefits. It is crucial to be aware of the filing deadlines and take prompt action to ensure that applications and reimbursement claims are submitted promptly. 

Denials of Retroactive Coverage Applications

Occasionally, individuals may face denials of their Medicaid Retroactive Coverage applications. This can occur for various reasons, such as incomplete or inaccurate information, missing documentation, or failure to meet eligibility criteria. When faced with a denial, it is crucial to understand the reasons behind it and explore options for rectifying the situation.

The Medicaid Appeals Process

If your Medicaid Retroactive Coverage application is denied, you have the right to appeal the decision. The appeals process allows you to challenge the denial and present your case to a higher authority. It typically involves submitting a written appeal with supporting evidence and participating in a hearing to present your arguments. Knowing the steps involved in the appeals process is crucial to effectively manage this procedure.

Legal Assistance for Appeals

Seeking legal assistance for appeals can significantly improve your chances of success. Medicaid planning attorneys experienced in appeals can help you understand the reasons for the denial, gather relevant evidence, and build a strong case. They can guide you through the appeals process, ensuring that all necessary documentation is submitted, and represent your interests during hearings. Working with a skilled attorney can provide valuable advocacy and increase the likelihood of a favorable outcome.

Changes and Updates to Medicaid Retroactive Coverage

Medicaid policies and regulations are subject to changes and updates over time. It is important to stay informed about any modifications or amendments that may impact Medicaid Retroactive Coverage. Regularly reviewing New York State’s Medicaid websites, consulting with Medicaid planning attorneys, or contacting local Medicaid offices can help you stay up to date with the latest changes and ensure that you are aware of any new eligibility criteria or procedural requirements.

Staying informed about denials, the appeals process, and seeking legal assistance when needed is crucial in handling the challenges of retroactive Medicaid. Additionally, keeping up to date with changes and updates to the program makes sure that you are aware of any new developments that may affect your eligibility or benefits. Staying proactive and seeking professional guidance allows you to effectively address denials, manage the appeals process, and remain informed about changes.

How an Experienced Long Island Medicaid Planning Attorney Can Help

Managing the requirements of Medicaid eligibility and the application process can be challenging.

• Eligibility Assessment: A Medicaid planning attorney can evaluate your circumstances, income, and assets to determine your eligibility for Medicaid retroactive coverage in New York. They will help you understand the specific criteria and requirements, ensuring that you meet the necessary qualifications.
• Application Preparation: Medicaid applications require careful completion and submission of various forms, supporting documents, and evidence of eligibility. A skilled attorney can guide you through this process, ensuring all necessary paperwork is completed accurately and efficiently. They will help gather the required documentation, such as financial records and medical evidence, to strengthen your application.
• Maximizing Benefits: Medicaid planning attorneys have in-depth knowledge of the Medicaid system and its intricacies. They can identify strategies and legal techniques to maximize your benefits, including retroactive coverage. By carefully structuring your assets and income, they can help you qualify for a greater range of services and receive retroactive reimbursement for past medical expenses.
• Appeals and Disputes: If your retroactive Medicaid application is denied or if there are issues with your benefits, a skilled attorney can assist you in filing appeals or resolving disputes. They will represent your interests, manage the appeals process, and advocate for a favorable outcome on your behalf.
• Long-Term Planning: Medicaid planning attorneys can provide guidance on long-term planning, including strategies to protect your assets and ensure eligibility for Medicaid benefits in the future. They can help you work through complicated Medicaid rules, such as asset transfer regulations, to preserve your financial security while accessing necessary healthcare services.

A skilled Medicaid planning attorney can help individuals understand retroactive Medicaid in New York, guide them through the application process, and maximize their benefits. Their experience can be invaluable in securing the necessary healthcare coverage and providing peace of mind for individuals and their families.

Service	Description	Key Benefits
Eligibility Assessment	Evaluation of circumstances, income, and assets to determine Medicaid eligibility for retroactive coverage in New York, ensuring compliance with criteria and requirements.	Clarifies eligibility requirements and increases chances of approval.
Application Preparation	Guidance in completing Medicaid applications, collecting required documents, and ensuring accuracy and efficiency in submission.	Reduces errors, speeds up approval, and ensures complete documentation.
Maximizing Benefits	Using legal strategies to structure assets and income to qualify for more services and retroactive reimbursement.	Increases the scope of services covered and potential reimbursements.
Appeals and Disputes	Representation in case of application denial, managing appeals, and advocating for favorable outcomes.	Improves chances of overturning denials and resolving disputes efficiently.
Long-Term Planning	Strategic planning to protect assets and ensure future Medicaid eligibility, navigating asset transfer rules.	Preserves financial security while maintaining access to healthcare services.

Consult an Experienced Medicaid Planning Attorney from Schlessel Law PLLC Today

If you or your loved ones require retroactive Medicaid in New York, seeking the assistance of a skilled Medicaid planning attorney can make a significant difference. They have the knowledge and experience to guide you through the eligibility criteria, application process, and reimbursement procedures. Enlisting the help of a Medicaid planning attorney allows you to move through the system effectively, maximize your chances of receiving retroactive benefits, and reduce the stress often associated with the process.

Contact Schlessel Law PLLC today at (516) 574-9630 to discuss your specific situation and learn how we can assist you. Do not let the challenges of retroactive Medicaid overwhelm you. Take action and secure the professional support you need to work through the system successfully and access the benefits you deserve.

from Schlessel Law https://www.schlessellaw.com/medicaid-retroactive-coverage-in-new-york-how-does-it-work/

Medicaid vs. Medicare: A Critical Guide for New Yorkers

The U.S. healthcare system can be complicated to tackle, especially when it comes to  comparing Medicaid and Medicare. Although both programs offer essential health coverage, they are designed for different groups and follow separate rules for eligibility, benefits, and enrollment. In New York, where healthcare and long-term care costs run high, having clear information about how these programs work can make a significant difference in planning and decision-making for yourself or a loved one.

For those looking to protect assets, plan for long-term care, or ensure they qualify for Medicaid without jeopardizing financial stability, consulting a Long Island Medicaid planning lawyer is essential. The nuances of Medicaid eligibility, especially when nursing home or home care coverage is needed, require strategic legal guidance. At Schlessel Law, PLLC, our experienced team of  Long Island Medicaid planning lawyers is here to help you understand the system with clarity and confidence. Call us today at (516) 574-9630 for a personalized consultation and get the legal support you need for smart, secure planning.

How Will You Pay for Long-Term Care in New York?

For countless New York families, planning for retirement and old age revolves around a central, often unspoken anxiety: the staggering cost of long-term care. Whether the need arises from a sudden illness or the gradual effects of aging, the financial impact can be devastating. In regions such as Long Island, the average monthly cost for nursing home care can exceed $14,900, with similarly daunting rates in New York City and Westchester. Faced with these figures, a lifetime of savings can disappear in a matter of months.

Medicare vs. Medicaid: A Critical Distinction

A widespread and dangerous misunderstanding lies in the roles of two government programs: Medicare and Medicaid. Their names sound alike, but their functions, eligibility rules, and coverage limits for long-term care are entirely different.

Many people assume that Medicare, the health insurance program they have contributed to throughout their working lives, will cover an extended stay in a nursing home or ongoing in-home care. This assumption can lead to catastrophic financial consequences.

• Medicare is designed for acute medical care, short-term needs such as doctor visits, hospital stays, and surgeries. It does not cover long-term custodial care.
• Medicaid, on the other hand, is the primary source of payment for long-term care in the United States. For seniors who need ongoing help with daily living, whether in a nursing facility or at home, Medicaid often becomes the only viable option.

Why Understanding This Difference Protects Your Future

The distinction between these programs is more than bureaucratic detail; it is a financial lifeline. Failing to understand it is one of the greatest risks to the financial security of New York seniors and their families. Without proper planning, families may have to resort to spending down assets rapidly to meet eligibility requirements or worse, face an inability to pay for the care they need.

Medicare: The Federal Health Plan and Its Critical Limits

Medicare is a federal health insurance program that forms the bedrock of healthcare for most older Americans. Understanding exactly what Medicare does, and more importantly, what it does not do, is the first step in responsible financial planning for later years.

Who Is Eligible for Medicare?

Medicare eligibility is based on age or disability, not on financial need. It is an entitlement program earned through years of paying Medicare taxes. In general, you are eligible for Medicare if you are a U.S. citizen or have been a legal resident for at least five years and meet one of the following criteria:

• Age 65 or older: This is the most common path to eligibility. Most individuals sign up during their Initial Enrollment Period, which begins three months before their 65th birthday.
• Under 65 with a qualifying disability: Individuals who have received Social Security Disability Insurance (SSDI) benefits for 24 months usually qualify, regardless of age.
• Any age with specific medical conditions: A diagnosis of End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease) may qualify someone for Medicare without a waiting period.

Because eligibility is not means-tested, your income and assets do not determine whether you qualify. However, as explained below, higher income levels can increase the premiums you pay.

The Real Cost of Medicare in 2025

While many people receive Medicare Part A (Hospital Insurance) without a monthly premium because of their work history, Medicare is far from free. Costs include premiums, deductibles, and coinsurance, all of which can add up quickly.

Part A covers inpatient care in hospitals and skilled nursing facilities, as well as hospice care and some home health services. For 2025, most people pay no monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Those with 30 to 39 quarters of coverage pay $285 per month, while those with fewer than 30 quarters pay $518 per month. There is also a hospital deductible of $1,676 for each benefit period. After meeting the deductible, the first 60 days of inpatient care are fully covered, but from days 61 through 90, there is a daily coinsurance of $419. For lifetime reserve days, the coinsurance jumps to $838 per day.

Part B covers doctors’ services, outpatient care, durable medical equipment, and preventive services. The standard monthly premium for Part B in 2025 is $185.00, but individuals with higher incomes pay more through an adjustment known as the Income-Related Monthly Adjustment Amount (IRMAA). For example, someone with a modified adjusted gross income above $106,000, or a married couple above $212,000, will face higher premiums. The annual deductible for Part B is $257, and after meeting it, most services require a 20 percent coinsurance payment.

The Long-Term Care Gap: Medicare’s 100-Day Coverage

The most critical limitation of Medicare is its near-total lack of coverage for long-term custodial care. Custodial care includes help with activities of daily living such as bathing, dressing, eating, and transferring. This is exactly the type of care that most nursing home residents need. Medicare does not pay for this kind of care.

The program does offer a very limited benefit for skilled nursing facility care, but strict rules and short timeframes create what many families experience as a financial cliff. To qualify for any skilled nursing facility coverage under Medicare Part A, all of the following must be true: 

• There must be a qualifying prior inpatient hospital stay of at least three consecutive days
• The individual must be admitted to the skilled nursing facility for the same condition that required hospitalization
• The admission to the facility generally must occur within 30 days of the hospital discharge.

Even when these conditions are met, the coverage is temporary. For the first 20 days in a skilled nursing facility, Medicare pays 100 percent of the cost. For days 21 through 100, Medicare pays only part of the cost, and the patient is responsible for a daily coinsurance payment of $209.50 in 2025. After day 100, Medicare pays nothing at all. From that point on, the individual is responsible for the entire cost, which can quickly reach many thousands of dollars each month.

This coverage structure is designed for short-term rehabilitation after an acute illness or injury, not for chronic conditions like Alzheimer’s, Parkinson’s, or severe frailty that require ongoing care for months or years. The abrupt shift from partial coverage to no coverage after day 100 is a financial shock for families who mistakenly believed Medicare would serve as a long-term safety net. Instead, they discover that the net disappears just as the need for support continues. This harsh reality is why understanding and planning around New York’s Medicaid program is not just helpful, it is absolutely essential.

What Sets New York Medicaid Apart From Medicare?

While Medicare falls short in covering long‑term care, New York’s Medicaid program steps in to fill this critical gap. For many middle‑class families, Medicaid is not a welfare program in the traditional sense. Instead, it is an essential financial planning tool, often the only way to afford long‑term nursing home or home‑based care without liquidating the assets built over a lifetime. Accessing these benefits, however, requires facing complicated and unforgiving financial eligibility rules.

The True Purpose of Medicaid for New York Seniors

Medicaid is a joint federal and state program that provides health coverage to low‑income individuals of all ages. While it supports many groups, including children and pregnant women, its most vital role for seniors is as the primary payer for long‑term care services. This includes full coverage for care in a residential nursing facility and coverage for home and community‑based services, such as personal care aides, adult day health care, and private duty nursing through programs like Managed Long‑Term Care.

Even seniors with strong Medicare coverage and supplemental insurance often find themselves turning to Medicaid once a chronic illness creates a need for ongoing care.

Passing New York’s Strict Financial Tests

Unlike Medicare, Medicaid is means‑tested. Eligibility is determined by a thorough review of both income and assets. In New York, the financial thresholds are very low, which means that without proactive planning, most seniors will not qualify until they have spent nearly all of their resources.

For 2025, an individual applying for long‑term care Medicaid in New York may not have more than $32,396 in countable assets. For those receiving care at home, the monthly income limit is $1,800, although excess income can often be managed through a pooled income trust. For those in a nursing home, almost all monthly income, including Social Security and pension payments, must be applied toward the cost of care. Only a small personal needs allowance of $50 per month can be kept.

The rules go beyond simple numbers. Certain assets are countable while others are exempt. Countable assets include cash, checking and savings accounts, stocks, bonds, investments, and any real estate other than the primary residence. Exempt assets include the primary residence (if the applicant or a spouse lives there and the equity value is under $1,097,000 in 2025), one automobile of any value, and retirement accounts such as IRAs and 401(k)s, as long as they are in payout status with required minimum distributions being taken. Pre‑paid funeral and burial arrangements are also exempt, as are most personal property and household furnishings.

These exemptions are not always obvious, and the rules can change. These nuances turn Medicaid eligibility from a straightforward checklist into a challenging legal puzzle.

The Five-Year Look-Back: Medicaid’s Memory

To prevent applicants from giving away assets to meet eligibility limits, New York Medicaid imposes a five‑year look‑back period for nursing home care. When someone applies, caseworkers review all financial records from the past 60 months. Any assets transferred for less than fair market value, such as gifts to family members, property sold at a steep discount, or large unexplained withdrawals, will trigger a penalty period.

This penalty period is calculated by dividing the value of the improper transfers by the average monthly cost of nursing home care in the applicant’s region. For example, in Long Island, where the average monthly cost is $14,914, a gift of $149,140 made within the look‑back period would result in a penalty period of 10 months. During those months, the individual would be responsible for paying all care costs out of pocket.

The look‑back rule makes it clear that New York rewards those who plan ahead. With discussions underway about implementing a 30‑month look‑back period for community‑based care in the future, the regulatory landscape is constantly evolving. This makes early planning and professional legal guidance not only helpful but absolutely essential to protect your life’s savings.

Feature	Medicare	Medicaid
Purpose	Covers acute medical needs	Covers long-term care needs
Type of care covered	Doctor visits, hospital stays, surgeries	Custodial care in nursing homes or at home
Long-term care	Not covered	Often the only viable option for long-term care
Payment source	Based on contributions during working years	Government program for those who qualify

Long Island Medicaid Planning Lawyer Seth Schlessel

Seth Schlessel is the Managing Member and Founder of Schlessel Law PLLC, a Long Island-based firm focused on elder law, estate planning, and Medicaid planning. With a hands-on approach to complex cases, Seth personally guides clients through the often-overwhelming process of securing long-term care benefits while preserving family assets. 

A graduate of Touro Law School in 2013, Seth held several leadership roles during his time there, including serving as Vice President of the Sports and Entertainment Society. He was admitted to the New York Bar in 2014 and has since built a reputation for delivering compassionate, results-driven legal counsel to families across Long Island.

A Guide for Married Couples: New York’s Spousal Impoverishment Rules

When one spouse needs long-term care and the other remains at home, families often face a difficult mix of emotional and financial pressures. To prevent this, federal law and New York State law provide important spousal impoverishment protections. These rules are not just a safety net; they form the foundation of effective Medicaid planning for married couples.

Preventing Poverty: The Goal of Spousal Protection

The guiding principle behind spousal impoverishment protections is to treat the couple’s finances as a whole while carving out a legally protected share for the community spouse. This ensures the spouse needing care can qualify for Medicaid without forcing the healthy spouse to give up everything. These protections create room for an experienced elder law attorney to help preserve a significant portion of a couple’s assets while still securing long-term care benefits.

A Deep Dive into the 2025 Protections

Two key protections safeguard the community spouse: the Community Spouse Resource Allowance (CSRA) and the Minimum Monthly Maintenance Needs Allowance (MMMNA).

Community Spouse Resource Allowance (CSRA)

This allowance sets the amount of combined countable assets the community spouse is allowed to keep. In 2025, New York allows the community spouse to retain up to $157,920, while ensuring they keep at least $74,820. The exact amount is calculated as one-half of the couple’s total countable resources, but it will never fall below the minimum or rise above the maximum. Importantly, this allowance is in addition to the $32,396 in assets that the applicant spouse is permitted to retain. This rule alone enables married couples to protect far more than single applicants.

Minimum Monthly Maintenance Needs Allowance (MMMNA)

This rule protects the community spouse’s income. In 2025, the community spouse is entitled to a total monthly income of up to $3,948. If the community spouse’s own income from wages, pensions, or Social Security is below this figure, they can receive a transfer of income from the institutionalized spouse to bring them up to the allowance. This transferred income is not counted against the applicant spouse’s Medicaid eligibility and helps ensure that the healthy spouse can meet their own living expenses.

Spousal Refusal

New York also offers a unique planning tool known as spousal refusal, often referred to as the “just say no” strategy. Through spousal refusal, the community spouse formally declares that they will not contribute their income or assets, beyond the protected allowances, toward the cost of care for the institutionalized spouse.

Once this refusal is in place, the applicant spouse’s eligibility for Medicaid is determined based solely on their own income and assets rather than the couple’s combined resources. This can allow for immediate qualification for benefits. However, spousal refusal is not a simple or risk-free tactic. The state and local social services agencies can later attempt to recover contributions from the community spouse, sometimes through court action. Used strategically and with the guidance of an experienced attorney, spousal refusal can provide critical relief while creating time and leverage to negotiate a fair resolution with the state.

Trusted Guidance from Schlessel Law, PLLC

Making informed decisions about Medicare and Medicaid can be overwhelming, especially with evolving regulations and high stakes for long-term care and financial security. At Schlessel Law, PLLC, we help New Yorkers understand both programs with personalized legal strategies that align with your health, family, and financial goals.

Don’t leave your future to chance. Call Schlessel Law, PLLC today at (516) 574-9630 to schedule a consultation with a knowledgeable attorney who can help you plan smartly and protect what matters most.

from Schlessel Law https://www.schlessellaw.com/medicaid-vs-medicare-a-critical-guide-for-new-yorkers/

Who Decides if a New York Resident is Incapacitated?

When someone in New York begins to struggle with memory, decision-making, or managing their daily life, it can be hard to know what to do next. Maybe it’s your parent, your spouse, a close friend, or maybe it’s you. These changes can bring a lot of questions and a fair amount of worry. One of the biggest questions is this: Who decides if a person can no longer take care of their own needs?

New York law looks at this through what’s called Article 81 of the Mental Hygiene Law. This law outlines how someone might be found legally incapacitated and what steps the court takes to make that decision. Sometimes, a family member, social worker, doctor, or even the person themselves starts this process by filing a request with the court. Other times, a judge might notice that someone is having a hard time during another legal case, like a housing issue or foreclosure, and step in to appoint a helper for just that situation.

If the need for help isn’t short-term, a more involved court process may follow. That process can lead to the appointment of a legal guardian, someone who can make choices about healthcare, money, or other personal matters. This can also include help setting up a healthcare proxy, so someone you trust can make medical choices if you can’t.

At Schlessel Law PLLC, we understand that these situations are deeply personal. If you’re feeling unsure or overwhelmed, you’re not alone. Our team of New York estate planning attorneys can walk with you through these choices, answer your questions, and help you put a plan in place that fits your needs. Call us at (516) 574-9630 to set up a consultation. We’re here to help you move forward with care and confidence.

What Is Incapacity Under New York Law and Who Decides It?

In New York, incapacity means you are unable to handle your own care or money because of physical or mental limitations. A judge makes this decision during a guardianship case brought under Article 81 of the Mental Hygiene Law.

The judge looks at many parts of your daily life. Can you pay your bills on time, keep clean, and stay safe? Do you grasp what may happen if you do not act? The court also reviews how you managed these tasks in the past. All of this guides the choice.

Trained helpers such as psychologists, social workers, or lawyers meet with you and study your situation. They write clear reports for the court, giving the judge more facts.

The main goal is to protect you while letting you keep as much freedom as possible. A finding of incapacity comes only when strong proof shows you cannot care for yourself or your property.

New York Estate Planning Attorney

Seth Schlessel

Seth Schlessel is the Managing Member and Founder of Schlessel Law PLLC, a New York-based estate planning firm known for its commitment to personalized legal guidance. Seth oversees daily operations, mentors the legal team, and leads in addressing client needs. His strategic vision and hands-on leadership ensure that every case is handled with precision and care.

Seth earned his law degree from Touro Law School in 2013, where he served in leadership roles, including as Vice President of the Sports and Entertainment Law Society. Admitted to the New York Bar in 2014, he has since built a reputation for his clear communication, deep legal knowledge, and unwavering dedication to client success in estate planning and elder law.

The Legal Process for Declaring Incapacity in New York

Declaring someone incapacitated in New York involves a formal legal process governed by Article 81 of the Mental Hygiene Law. This approach guarantees that decisions about an individual’s capacity are made with careful oversight and adherence to the law. 

This process begins with the filing of a guardianship petition. The petitioner, often a family member or concerned party, submits detailed documentation to the court outlining the alleged incapacitated person’s (AIP) inability to manage personal or financial affairs. This petition must include evidence of the AIP’s condition and its impact on their daily life.

Once the petition is filed, the court appoints an independent evaluator to assess the AIP’s situation. Their role is to interview the AIP, review their medical and financial circumstances, and provide a detailed report with observations and recommendations to the court.

A hearing is then scheduled, during which the petitioner and the AIP can present evidence and testimony. If the AIP opposes the guardianship, they may have legal representation, and a jury trial may be requested to resolve contested issues.

The court bases its decision on clear and convincing evidence of the AIP’s incapacity. The judge evaluates factors such as the AIP’s ability to perform daily activities, manage property, and understand the consequences of their actions. If the court finds incapacity, a guardian is appointed. This guardian’s authority is carefully tailored to protect the AIP’s rights and maintain as much independence as possible while addressing their needs.

This structured process safeguards the rights of all involved and emphasizes a balanced approach to personal independence and protection.

Step	Description
Filing of Petition	A concerned party submits detailed documentation to the court outlining the AIP’s inability to manage personal/financial affairs.
Appointment of Evaluator	The court appoints an independent evaluator to assess the AIP’s condition, including medical and financial circumstances.
Evaluator’s Report	The evaluator submits a detailed report with observations and recommendations regarding the AIP’s capacity.
Hearing and Evidence Review	Both sides present evidence and testimony; the AIP may have legal representation and request a jury trial if contested.
Judicial Decision	The court decides based on clear and convincing evidence and appoints a guardian if incapacity is proven.
Guardian Appointment	The guardian’s authority is tailored to protect the AIP’s rights while meeting their needs.

Criteria for Incapacitation

No specific diagnosis is required, though evidence of a diagnosis can help shore up a case. For example, if a petitioner has evidence that the Alleged Incapacitated Person (AIP) has been diagnosed with Alzheimer’s, then this can help strengthen their case.

Rather, the court is attempting to determine if:

• A person is likely to suffer harm because they are unable to provide for their personal needs.
• They’re also likely to suffer harm because they can’t manage their property.
• The person cannot adequately understand or appreciate the nature and consequences of such inability.

The court must consider a number of factors in these cases, including the person’s ability to manage the activities of daily living and the ways that the AIP has been managing their affairs to date. If an estate plan is in place, then the courts must consider the person’s wishes.

New York’s ‘Least Restrictive Means’ Rule for Guardianships

New York’s Mental Hygiene Law Article 81 puts your choice first. Section 81.03 says a court may give only the powers that match the help you truly need. This is the state’s least restrictive means rule. The judge looks at your daily skills, the support you already have, and the harm that could come if nothing is done. The goal is freedom plus safety.

When deciding, the court must pick the most straightforward path. It first tests lighter tools like a health care proxy, power of attorney, joint bank account, or supported decision-making. If those tools work, no guardian is named. If they do not, the court writes an order that fills only the real gaps in care or money work. The plan can grow or shrink later as life changes.

Powers come in two main sets. A property-only guardian keeps the books. Think paying rent, filing taxes, selling a house, stopping scams, and sending reports to the clerk. You keep the right to choose doctors, friends, and where to live. A personal-needs guardian steps into those closer parts of life. They may approve surgery, hire aides, pick housing, and open your mail. Many cases mix both sets, but each duty is granted line by line.

How a Skilled New York Estate Planning Lawyer Can Help

The process of determining incapacity and navigating guardianship proceedings in New York can be challenging and an emotional process for all parties involved. For anyone facing such a situation, a thorough comprehension of the legal criteria, the steps involved, and the potential outcomes is essential.

If you or a loved one are facing a potential guardianship situation due to incapacity, or wish to proactively plan for the future, it is crucial to have an experienced New York estate planning lawyer by your side.

At Schlessel Law PLLC, our team of skilled estate planning attorneys may be able to help you navigate the legal system, protect your rights and assets, and ensure that your wishes are respected. Contact us today at (516) 574-9630 to discuss your options and safeguard your future.

from Schlessel Law https://www.schlessellaw.com/who-decides-if-a-long-island-resident-is-incapacitated/

Costly Medicaid Planning Myths New York Families Still Believe

Planning for Medicaid isn’t something you want to take lightly. A lot of folks think they’ve got it all figured out; they heard something from a friend, read an article online, or assume they have too much money to qualify. But the truth is, believing in these common Medicaid myths can end up costing you real benefits. Worse, it could put your savings, your home, and even your care at risk. That’s why having the right guidance matters from the start.

At Schlessel Law PLLC, working with our seasoned Long Island Medicaid planning attorneys means you’re not left guessing. You’ll get clear, practical advice that helps you avoid the most common pitfalls people fall into, like gifting away assets too late, missing key paperwork, or assuming a will protects everything. The process doesn’t have to be overwhelming, but it does take careful steps, and that’s where experience counts. If you’re planning for yourself or helping a loved one, take the time to talk with someone who does this work every day. It’s one conversation that could save you a lot of stress and money down the line. Contact us today at (516) 574-9630 for a free consultation.

Don’t Let These Medicaid Myths Cost Your Family Everything

Let’s be honest, Medicaid planning in New York can feel stressful. You’ve probably heard stories from friends or family that made you worry about losing everything you’ve worked for. But here’s the thing: a lot of that fear is based on misinformation. So let’s clear up some of the biggest myths that could be putting your financial future and your family’s at risk.

Thinking You Have Too Much Money to Qualify for Medicaid

You might believe that your income or assets are too high for Medicaid eligibility. However, New York’s 2025 Medicaid guidelines allow individuals to have up to $1,800 in monthly income and $32,396 in assets. For married couples, the limits are $2,433 in monthly income and $43,781 in assets. Additionally, if one spouse is applying for nursing home Medicaid, the non-applicant spouse can retain up to $157,920 in assets.

Certain assets, like your primary residence (up to $1,097,000 in equity), are exempt. Moreover, strategies such as pooled income trusts can help manage excess income while maintaining eligibility. 

Why Waiting Until a Crisis Hits is a Costly Mistake

Delaying Medicaid planning until a health crisis arises can be financially detrimental. New York enforces a five-year lookback period for nursing home Medicaid. This means any asset transfers made within five years before applying can trigger penalties, delaying eligibility.

Starting in 2025, a 30-month lookback period is also planned to be implemented to community-based Medicaid services, such as home care. Planning ahead allows you to make informed decisions, protect your assets, and ensure timely access to care.

The Real Story on Protecting Your Life Savings

You’ve worked hard for what you have. Your house, your retirement accounts, your savings, they shouldn’t be wiped out because you need long-term care.

You don’t have to give everything away to protect it. And you definitely don’t need to wait until you’re flat broke. There are legal tools available right here in New York that let you keep control of your money and still get Medicaid. 

This isn’t about gaming the system. It’s about planning wisely, using the laws that are already in place to protect your family’s future.

If you’ve heard that applying for Medicaid means losing your home or draining your savings, you’ve been given bad advice. Taking the time to understand and plan for Medicaid can make a significant difference in preserving your family’s financial well-being.  Don’t let those myths make you hesitate. The sooner you take action, the more options you’ll have, and your future self and your family will thank you for it.

Long Island Medicaid Planning Attorney – Seth Schlessel

Seth Schlessel

Seth Schlessel is the Managing Member and Founder of Schlessel Law PLLC, a Long Island-based firm focused on estate planning, elder law, and Medicaid planning. Since earning his law degree from Touro Law School in 2013 and admission to the New York Bar in 2014, Seth has guided individuals and families through the legal processes of wills, trusts, probate, and long-term care planning.

At Schlessel Law PLLC, Seth oversees daily operations and handles complex cases, providing clients with personalized strategies to protect their assets and legacies. His dedication to clear communication and tailored legal solutions has established the firm as a trusted resource for estate planning needs in Nassau and Suffolk counties.

Is Gifting Your Assets to Your Kids Really the Best Move?

Thinking about giving your home or savings to your children to qualify for Medicaid? It might seem like a smart way to protect your legacy, but in New York, this approach can backfire. Let’s break down what you need to know to avoid costly mistakes.

How Does the Medicaid Look-Back Period in New York Work?

In New York, Medicaid has a five-year “look-back” period for nursing home care applications. This means that any gifts or transfers of assets made within five years before applying for Medicaid are scrutinized. If you’ve given away assets during this time, Medicaid may impose a penalty period during which you’re ineligible for benefits.

For example, if you gifted $60,000 to your children, and the average monthly cost of nursing home care is $6,000, you can face a 10-month penalty period where Medicaid won’t cover your care.

How Giving Away Your Home Can Backfire

Transferring your home to your children might seem like a way to protect it, but it can have unintended consequences. If you transfer your home and then apply for Medicaid within five years, the transfer could trigger a penalty period, delaying your eligibility for benefits.

Moreover, if your children decide to sell the home, they might face significant capital gains taxes, especially if the home’s value has appreciated since you purchased it.

The Hidden Tax Consequences for Your Children

Gifting assets to your children can also have tax implications. While New York doesn’t have a gift tax, the federal government does. In 2025, you can gift up to $19,000 per recipient without filing a gift tax return. However, any amount above that requires filing, and while you might not owe taxes immediately, it reduces your lifetime exemption.

And, as mentioned, if your children sell the gifted assets, they might owe capital gains taxes based on your original purchase price, which could be significantly lower than the current market value.

Safer Ways to Transfer Assets for Your Heirs

Instead of outright gifting, consider these alternatives:

• Medicaid Asset Protection Trust (MAPT): Placing assets into a MAPT can protect them from Medicaid’s asset calculations, provided it’s done at least five years before applying for nursing home Medicaid.
• Life Estate Deed: This allows you to retain the right to live in your home for the rest of your life, with the property transferring to your heirs upon your death, potentially avoiding probate and reducing capital gains taxes.
• Spousal Transfers: Transferring assets to a spouse is generally exempt from Medicaid’s look-back rules, providing a way to protect assets without penalties.
• Caregiver Agreements: If a family member is providing care, formalizing this arrangement with a written agreement can allow for compensation without violating Medicaid rules.

Before making any decisions, it’s crucial to consult with a professional familiar with New York’s Medicaid laws to ensure your plans align with current regulations and protect your family’s financial future.

Why Your Will Won’t Protect Your Assets from Medicaid Costs

If you think a will is enough to keep your home or savings safe from Medicaid, you’re not alone, but you may be in for a surprise. A will decides who gets what after you pass away, but it doesn’t shield anything from Medicaid. In New York, Medicaid can still come back for repayment. That’s why it’s so important to know what really happens after you’re gone and what you can do while you’re still here.

The Difference Between Probate and Medicaid Estate Recovery

In New York, Medicaid can seek reimbursement for the costs of your care from your estate after you pass away. This process is known as estate recovery. It applies to assets that go through probate, that is, assets solely in your name without designated beneficiaries.

So, if your will leaves your house to your children, but it’s still in your name alone, Medicaid can place a claim against it during probate. This means your heirs might have to sell the home to pay back Medicaid, even if your will says otherwise.

How Medicaid Can Claim Assets After You’re Gone

In New York, Medicaid can file a claim against your estate for the cost of the services you received. It doesn’t matter what your will says. Medicaid gets in line with your other creditors, and in some cases, they go straight to the front.

New York’s estate recovery rules are broader than you might expect. The state can pursue assets that:

• Are part of your probate estate (like property solely in your name)
• Were jointly owned but pass to someone else upon your death
• Are in certain types of trusts that don’t meet specific criteria

This means that even assets you thought would bypass probate could be subject to Medicaid’s claim. Your family could be surprised to find that accounts or property they expected to inherit are now tied up in repayment processes.

Here’s what this might look like: you pass away with your house in your name, and your will says it should go to your children. But you used Medicaid to pay for home care or nursing home care. The state then sends a bill to your estate for those services. If there’s no cash to pay it, your home may have to be sold to settle the debt.

This happens more often than you might think. And once the estate is opened in court, it’s public. That makes it even easier for Medicaid to file a claim.

Using Trusts to Safeguard Your Legacy

To protect your assets from Medicaid estate recovery, consider setting up a Medicaid Asset Protection Trust (MAPT). Here’s how it works:

• Irrevocable Trust: Once you place assets into a MAPT, you can’t take them back. This might sound restrictive, but it means those assets aren’t considered yours for Medicaid purposes.
• Timing Matters: Transfers into a MAPT must be made at least five years before you apply for Medicaid to avoid penalties.
• Control and Use: While you can’t access the principal, you can still receive income generated by the trust, and your designated trustee manages the assets according to your wishes.

By planning ahead and using a MAPT, you can help ensure that your assets go to your intended beneficiaries, not to repay Medicaid. It’s a proactive step that can provide peace of mind for you and your family.

Believing You Can Hide Assets from Medicaid Scrutiny

It might be tempting to think you can tuck away some money or put property in someone else’s name, and Medicaid won’t find out. Maybe someone you know even told you they “got away with it.” But let’s be clear: in New York, Medicaid takes asset reporting very seriously, and trying to hide anything can backfire fast.

How Medicaid Finds Your Financial Information

You might assume that small transfers or undisclosed accounts will go unnoticed. However, New York’s Medicaid program has systems in place to detect such activities. When you apply for Medicaid, you’re required to provide comprehensive financial information, including:

• Bank statements
• Property deeds
• Investment accounts
• Trust documents

The state reviews financial records from the past five years to identify any transfers or gifts that could affect your eligibility. This “look-back” period is designed to prevent individuals from giving away assets to qualify for Medicaid benefits. 

The Serious Penalties for Attempting to Defraud Medicaid

Trying to outsmart the system isn’t just risky, and it can have serious consequences. If Medicaid finds out you left out assets or made transfers you didn’t report, here’s what could happen:

• Your application could be denied, leaving you to pay out-of-pocket until you reapply correctly.
• You could face a penalty period, meaning you won’t get Medicaid coverage for a certain number of months.
• In some cases, there could be legal consequences, including criminal charges for fraud.

Even if the mistake wasn’t intentional, leaving something out or misreporting can still cause delays, stress, and potentially a lot of financial damage. Medicaid doesn’t give the benefit of the doubt when it comes to missing information.

Why Honesty is the Best (and Only) Policy in Your Application

It might be tempting to think that small omissions or transfers won’t be detected, but the risks far outweigh any perceived benefits. New York’s Medicaid program is designed to assist those in genuine need, and the application process includes thorough checks to verify eligibility.

Getting help with the application process doesn’t mean hiding anything, it means doing things the right way, with your long-term security in mind. Being transparent about your financial situation allows you to explore legitimate avenues for qualifying for Medicaid. There are legal strategies to protect certain assets and still meet eligibility requirements, but these must be approached correctly and within the bounds of the law.

If you’re unsure about how your assets affect your Medicaid eligibility, it’s crucial to seek guidance. Professionals familiar with New York’s Medicaid laws can provide advice tailored to your situation, helping you make informed decisions without risking your benefits or legal standing.

Remember, the goal is to secure the care you need without compromising your financial future or facing legal repercussions. Honesty and proper planning are your best tools in achieving that.

Your Bank Account Isn’t the Only Asset Medicaid Looks At

When you’re applying for Medicaid in New York, it’s easy to focus solely on your bank account balance. But Medicaid considers a broader picture of your financial situation. Let’s explore some assets that might impact your eligibility.

How Your Retirement Accounts Factor into Eligibility

In New York, retirement accounts like IRAs and 401(k)s are treated differently depending on their status. If your retirement account is in “payout status,” meaning you’re receiving regular, required minimum distributions, the principal is generally not counted as an asset. However, the income you receive from these distributions will be considered when evaluating your Medicaid eligibility. 

If your retirement account is not in payout status, the entire value of the account may be considered a countable asset, potentially affecting your eligibility. 

The Truth About Your Life Insurance Policies

Life insurance policies can also influence your Medicaid eligibility, depending on the type and value of the policy:

• Term Life Insurance: These policies do not accumulate cash value and are generally not counted as assets for Medicaid purposes.
• Whole Life Insurance: If the total face value of all your whole life policies exceeds $1,500, the cash surrender value (the amount you’d receive if you canceled the policy) is considered a countable asset. 

It’s important to review your life insurance policies to understand how they might impact your Medicaid application.

Why Your Spouse’s Assets Aren’t Automatically Safe

In New York, when one spouse applies for Medicaid, the assets of both spouses are considered in determining eligibility. This includes assets solely in the name of the non-applicant spouse. 

However, New York allows for a strategy known as “spousal refusal,” where the non-applicant spouse can legally refuse to contribute their assets toward the applicant spouse’s care. While this can help the applicant qualify for Medicaid, it’s important to note that Medicaid may still seek reimbursement from the non-applicant spouse’s assets after the applicant’s death. 

Understanding how your spouse’s assets are treated is crucial in Medicaid planning.

Being aware of how various assets affect Medicaid eligibility in New York can help you make informed decisions and plan effectively for your future care needs.

“I Don’t Need a Lawyer, I Can Handle Medicaid Planning Myself”

It’s easy to think, “I’ve filled out plenty of forms in my life. I can figure out Medicaid on my own.” And sure, if you’re used to handling paperwork, it might feel like something you can tackle solo. But Medicaid planning in New York isn’t just about filling out forms. It’s about timing, rules, and how your choices today can affect your care and your family’s future for years to come.

The Risks of DIY Medicaid Applications

You might not see the risks right away. But a small mistake can have big consequences. Medicaid in New York looks closely at how your finances have been handled in the past five years. A missed detail, wrong date, or incomplete answer can hold things up or even lead to a denial.

Some common issues people run into when applying on their own include:

• Not knowing which assets count against the limit
• Transferring money or property at the wrong time
• Thinking a simple will or power of attorney covers everything
• Missing required documentation, leading to delays or rejections

When these things happen, it’s not just a hassle; it can cost you months of coverage, force you to spend down your savings, or delay care you need now.

How a Medicaid Planning Attorney Saves You Money in the Long Run

Hiring someone to help with Medicaid planning might feel like an extra expense, especially if you’re trying to protect your finances. But the truth is, the right legal guidance often saves more than it costs.

A Medicaid planning attorney can:

• Help you legally protect assets using New York-approved strategies such as Medicaid spend-down
• Avoid unnecessary penalties and coverage delays
• Set up trusts such as an MAPT or other tools to preserve your home or savings
• Make sure your application is complete and ready the first time

That means you’re less likely to get stuck paying out-of-pocket for care while you wait for approval. It also means fewer surprises for your family down the road. A little planning now can keep you from facing big bills later.

Stay Updated with New York Medicaid Law

New York’s Medicaid laws have unique features that differ from other states. For instance, the state has specific rules regarding asset transfers and spousal protections. An experienced attorney can help you understand these nuances and develop a plan tailored to your situation.

Moreover, Medicaid laws and regulations can change. Staying updated on these changes is crucial to maintaining your eligibility and protecting your assets. An attorney stays informed about these developments and can adjust your plan accordingly.

In short, while it might be tempting to handle Medicaid planning on your own, the potential pitfalls can be significant. Consulting with a knowledgeable attorney can provide peace of mind and financial security for you and your loved ones.

Taking the Right Steps to Secure Your Future and Your Care

Planning for long-term care might not be something you want to think about right now, but taking action today can make a big difference for you and your family down the road. In New York, there are ways to protect your assets and still qualify for Medicaid when the time comes. Let’s look at some practical steps you can take.

The Power of a Medicaid Asset Protection Trust

One of the most effective tools available in New York is a Medicaid Asset Protection Trust, also called a MAPT. This kind of trust lets you move certain assets out of your name so they aren’t counted when Medicaid looks at your finances.

Here’s the key: once assets are in the trust, they’re no longer considered yours. But that doesn’t mean you lose everything.

• You can still live in your home if it’s in the trust.
• You can still receive income from trust investments, if set up that way.
• The assets stay protected from Medicaid’s look-back for nursing home care, as long as they’ve been in the trust for at least five years.

This trust helps you keep control over how your property is handled after you’re gone, while making sure Medicaid doesn’t eat up your life savings in the meantime.

However, timing is crucial. In New York, there’s a five-year look-back period for nursing home Medicaid applications. This means you should establish a MAPT at least five years before you anticipate needing long-term care to avoid potential penalties.

How to Plan Ahead for Long-Term Care Needs

Long-term care can be expensive, and relying solely on savings or insurance might not be sufficient. Planning ahead allows you to explore options like MAPTs and other strategies to protect your assets and ensure you receive the care you need.

Consider the following steps:

• Assess your financial situation: Understand your assets, income, and potential long-term care costs.
• Explore legal tools: Look into trusts, such as MAPTs, that can help protect your assets while maintaining Medicaid eligibility.
• Consult with professionals: Seek guidance from legal and financial advisors familiar with New York Medicaid laws to develop a plan tailored to your needs.

When you plan early, you’re not boxed into emergency decisions. You get the chance to protect your home, prepare for expenses, and qualify for help when you need it.

Starting the Conversation with Your Family Today

Talking about long-term care and financial planning with your family might be uncomfortable, but it’s an essential conversation. Open communication ensures everyone understands your wishes and can help you make informed decisions.

Let them know:

• What kind of care you’d want
• Who you trust to make decisions if you can’t
• Where you keep important documents
• How you’ve taken steps to protect your finances

These conversations don’t have to be long or heavy. Just honest. A simple talk today can prevent confusion and tension down the line. It also gives your family a chance to support your choices, instead of having to guess what you would’ve wanted.

Taking action now gives you peace of mind later. Your care, your choices, your legacy; it’s worth planning for.

Get the Right Help Before It’s Too Late

Medicaid planning isn’t something you want to get wrong. A simple mistake or a belief in the wrong advice can end up costing you benefits, money, or even the care you need. That’s why it helps to have someone in your corner who deals with this every day. 

Working with a Long Island Medicaid planning attorney from Schlessel Law PLLC gives you a clear path forward. You’ll have someone to walk you through what really matters, explain the rules in plain language, and help you avoid the traps that catch so many families off guard. If you’re thinking about your future or helping someone you love with theirs, don’t wait until you’re in a tough spot. Schedule a consultation today at (516) 574-9630, ask your questions, and get peace of mind that your planning is on the right track.

from Schlessel Law https://www.schlessellaw.com/costly-medicaid-planning-myths-new-york-families-still-believe/

Can an Executor Decide Who Gets What?

When a loved one passes, looking after their estate can feel heavy. The law and the will set clear rules for the person chosen to serve as executor. That person must follow the will word for word. An executor cannot pick and choose which heir receives a certain house, bank account, or keepsake. This simple rule keeps the process fair and within New York law.

If you are an heir hoping to protect your share or an executor trying to do the job the right way, steady support from a Long Island estate planning attorney at Schlessel Law PLLC can help. Our team can walk you through each step of probate, answer tough questions in plain language like the difference between an executor and an administrator, and guide you toward amicable solutions. We can help heirs know their rights and guide executors so every duty is handled with care and respect.

The will already decides who receives each asset, so the executor does not make that call. Sound legal help can ease family worry, keep paperwork in order, and keep trust strong between all involved. Contact Schlessel Law PLLC today at (516) 574-9630 to schedule a consultation and learn more about how we can help.

Duties of an Executor in New York

Choosing the person who will carry out your last wishes is a big step, and it can feel personal. Your executor does not decide who gets your house, bank account, or family heirlooms; your will already does that. The executor’s job is to gather your things, pay what you owe, and hand each gift to the people you named.

Some folks worry an executor might bend the rules. New York puts clear rules in place and backs them with real penalties if someone steps out of line.

Knowing these guardrails lets you breathe easier as you shape your plan. Your words stay in place long after you are gone, and any misuse of your estate meets a legal answer.

Legal Responsibilities and Obligations

An executor, appointed through a will, is tasked with the crucial role of managing the deceased’s estate. Despite common misconceptions, executors cannot alter the beneficiary designations or the asset distribution as detailed in the will. However, their primary responsibilities include:

• Gathering and Safeguarding Assets: Locating all estate assets and ensuring their security throughout the probate process.
• Settling Debts and Taxes: Paying off any debts and taxes owed by the estate before distributing assets.
• Distributing Assets to Beneficiaries: Allocating the remaining assets in accordance with the will’s directives.
• Legal Filings: Completing and filing necessary legal documents to validate the will and close the estate.

In New York, executors must adhere to specific legal obligations that safeguard the interests of the estate’s beneficiaries and creditors. These duties encompass:

• Fiduciary Duty: Acting with the highest levels of honesty and good faith, prioritizing the estate’s interests.
• Efficiency in Duties: Performing tasks promptly to ensure a smooth and timely probate process.
• Accurate Record-Keeping: Maintaining detailed records and providing accurate accounting to the court and all involved parties.

While the executor has significant responsibilities in managing and distributing the estate, they do not have the power to alter the distribution of assets as determined by the will. This key point helps to clarify expectations and promote a smoother probate process, reinforcing the importance of a well-crafted will in estate planning.

Long Island Estate Planning Attorney

Seth Schlessel

Seth Schlessel is the Managing Member and Founder of Schlessel Law PLLC, a boutique law firm dedicated to estate planning and elder law on Long Island. Seth directs the daily operations of the firm and personally handles its most high-stakes cases. His hands-on approach ensures that clients receive attentive, knowledgeable, and personalized legal service, especially in matters that demand careful, strategic planning.

Seth earned his J.D. from Touro Law School in 2013, where he distinguished himself through multiple leadership roles, including serving as the Vice President of the Sports and Entertainment Society. Since being admitted to the New York Bar in 2014, Seth has built a practice grounded in trust, compassion, and forward-thinking legal solutions for individuals and families navigating the estate planning.

What an Executor Can and Cannot Do with Estate Assets

The role of an executor in managing estate assets is strictly governed by the directives in the deceased’s will and the applicable state laws. An executor is authorized to collect the estate’s assets, settle debts, and distribute the remaining assets to the beneficiaries as outlined in the will. They may also sell assets if necessary for the efficient settlement of debts or distribution of the estate. However, executors are prohibited from using estate assets for personal benefit and from making decisions that contravene the terms of the will or unfairly favor one beneficiary over another unless explicitly authorized by the will or a court order.

Consequences of Overstepping Authority

When an executor oversteps their bounds, there are significant consequences:

• Legal Actions: Beneficiaries can file complaints or lawsuits if they believe the executor is not fulfilling their responsibilities or has breached their fiduciary duties.
• Financial Liability: If found liable, executors may have to compensate the estate for any losses incurred due to their actions.
• Removal from Role: In severe cases, a court can remove an executor for failing to comply with the terms of the will or for violating state law.

Respecting the legal boundaries of an executor’s authority is essential to the successful administration of an estate. Executors must adhere strictly to the provisions of the will and the laws of New York to protect themselves from legal repercussions and to ensure that the estate is managed and distributed correctly and fairly.

Executor’s Powers	Executor’s Limitations
Collect the estate’s assets	Cannot use estate assets for personal benefit
Settle debts	Cannot make decisions that contravene the terms of the will
Distribute remaining assets to beneficiaries as per the will	Cannot unfairly favor one beneficiary over another
May sell assets if necessary for settling debts or distribution	Must comply with the will and/or court orders

Executor’s Decision-Making Process for Asset Distribution

The role of an executor in the distribution of assets is pivotal in estate planning, particularly under the guidelines of New York estate laws. Here, we outline the decision-making process an executor may follow to distribute assets from an estate, ensuring that the will’s directives are adhered to and that any conflicts among beneficiaries are managed judiciously.

How Executors Interpret Wills and Testaments

Executors are tasked with interpreting the provisions of wills and testaments to determine how assets should be distributed among the beneficiaries. This process involves:

• Clarifying Ambiguities: When terms or instructions in the will are unclear, executors must seek clarification, often consulting with legal professionals to align with New York legal standards.
• Following Explicit Instructions: Executors must adhere closely to the specific directives laid out in the will, distributing assets exactly as the deceased intended.
• Legal Guidance: In cases where the will’s instructions might contradict New York law, executors are responsible for reconciling these issues in a manner that remains faithful to the testator’s intentions while complying with legal requirements.

Role of Executor in Resolving Conflicts Among Beneficiaries

Conflict among beneficiaries can arise during the asset distribution process. The executor’s role in such instances includes:

• Mediating Disputes: Executors act as mediators to help resolve disputes among beneficiaries amicably, aiming to uphold the wishes of the deceased while maintaining harmony among all parties.
• Legal Intervention: If disputes escalate, executors may need to seek judicial intervention to resolve the issues in accordance with New York law.
• Transparent Communication: Maintaining open lines of communication with all beneficiaries is crucial for executors to explain decisions and manage expectations effectively.

The executor’s decision-making process in asset distribution is guided by a commitment to uphold the legal and ethical standards prescribed by New York law. Executors play a critical role in ensuring that the distribution process respects the wishes of the deceased and the rights of the beneficiaries.

When the Will is Vague: What’s an Executor to Do?

When a will leaves room for doubt, you may feel stuck. A puzzling phrase like “share the house fairly” might sound kind, yet it tells you little about who gets what part. Start with the basics. Read the whole document line by line, pulling together deeds, bank records, and family letters that might shed light on the writer’s real aim. Speak with the heirs right away. An honest conservation can clear up simple mix-ups before they grow into court fights.

If any uncertainties remain, New York law provides a clear way forward. Under the Surrogate’s Court Procedure Act section 1420, the trustee can file a “construction” petition. This formal step asks the judge to rule on the meaning of the unclear language. The court will schedule a hearing promptly and look at outside proof, such as past gifts or old drafts, to decide. While the case is open, keep estate funds in a separate account and log every move. Careful records can guard you from claims of bias.

Do not try to guess. A wrong choice can put your own pocket at risk because heirs may sue for losses. When time, tax limits, or hard feelings add extra weight, calling a seasoned Long Island estate lawyer can help. Your lawyer can write the petition, gather proof, and stand with you in Surrogate’s Court so that the final order reflects the decedent’s real voice and shields you from blame. Prompt legal counsel also often pays for itself by cutting delays and keeping family peace.

Common Misconceptions About Executor Powers

Several misconceptions persist regarding the powers and duties of an executor. This section aims to clarify these misconceptions, providing accurate insights into what executors can and cannot do, which is essential for residents of Long Island engaged in planning their estates.

Myth vs. Reality: Can Executors Alter Wishes in a Will?

Myth: Executors have the ability to modify the distribution of assets outlined in a will based on their discretion or judgment.

Reality: Under New York law, executors are legally bound to follow the instructions specified in the will. They do not possess the authority to alter the deceased’s wishes regarding asset distribution. Their role is to execute the will as written, ensuring that each directive is fulfilled as intended by the deceased.

Clarifying the Executor’s Role in Asset Valuation and Distribution

The executor’s responsibilities include valuing and distributing assets, but their role is often misunderstood:

• Valuation Process: Executors must oversee the valuation of estate assets, which is crucial for determining how assets will be distributed according to the will’s specific instructions. This often involves hiring professional appraisers to ensure accurate asset valuation.
• Distribution Oversight: Following valuation, executors are tasked with distributing assets among beneficiaries strictly according to the will’s directives. They must manage this process fairly and transparently, without favoring any beneficiary over another.

Debunking Myths About Executor’s Personally Profiting from the Estate

Myth: There is a common misconception that executors can benefit personally from the estate they are managing.

Reality: While executors may receive a fee for their services, which is standard practice to compensate for the time and effort involved in managing the estate, they are prohibited from profiting beyond what is legally stipulated. New York law enforces strict fiduciary duties, requiring executors to act in the best interests of the estate and its beneficiaries, not for personal gain.

Executors are often misunderstood in their role and capabilities. It is vital to recognize that their primary function is to facilitate the wishes of the deceased as expressed in the will, while adhering to the legal framework provided by New York estate laws. Clearing up these misconceptions helps in maintaining transparency and trust in the estate planning and execution process.

Legal Rights of Beneficiaries Regarding Executor Decisions

Beneficiaries have specific legal rights that allow them to oversee and sometimes challenge the decisions made by executors. This section delineates these rights and the mechanisms in place to ensure that executors act in accordance with the law and the intentions of the decedent, particularly for estates managed on Long Island.

How Beneficiaries Can Challenge an Executor’s Decisions

Beneficiaries are not without recourse if they believe an executor is not fulfilling their duties properly. They have the right to:

• Requesting an Accounting: Beneficiaries can formally request a detailed report from the executor, which outlines all financial transactions and decisions made throughout the administration of the estate.
• Filing a Complaint in Surrogate’s Court: If beneficiaries suspect misconduct or are dissatisfied with the handling of the estate, they can file a petition in the Surrogate’s Court requesting a review of the executor’s actions.
• Seeking Removal of the Executor: In cases of significant breach of fiduciary duty, beneficiaries can ask the court to remove an executor who is found to be acting against the estate’s best interests or in violation of New York estate laws.

Understanding Beneficiaries’ Entitlements Under New York Estate Law

Under New York law, beneficiaries have defined entitlements that executors must respect:

• Right to Receive Specific Bequests: Any items or sums of money explicitly left to beneficiaries must be distributed as directed by the will.
• Right to a Timely Distribution: Beneficiaries are entitled to receive their inheritances within a reasonable timeframe, subject to the estate’s debts and liabilities being settled.
• Right to Fair Treatment: Executors are required to treat all beneficiaries impartially, managing the estate without favoritism and adhering strictly to the directives of the will.

Communication and Transparency Between Executors and Beneficiaries

Effective management of an estate involves maintaining open lines of communication between the executor and the beneficiaries:

• Regular Updates: Executors should provide regular updates about the progress of the estate’s administration, including the status of asset distribution and any issues that may arise.
• Accessible Information: Beneficiaries have the right to be informed about their rights and about any actions the executor takes on behalf of the estate.
• Prompt Responses to Inquiries: Executors are obliged to respond promptly and thoroughly to any queries from beneficiaries regarding their decisions or the state of the estate.

Adherence to these practices ensures a smooth estate administration process, reducing the potential for disputes and increasing satisfaction for everyone involved. This framework not only upholds the legal rights of beneficiaries but also fosters a transparent and accountable administration of estates on Long Island, in line with New York estate laws.

Get Top-Rated Probate Assistance From Schlessel Law PLLC Today

In New York, the role of an executor is pivotal in estate administration, involving the management and distribution of assets in accordance with the decedent’s documented wishes and state laws. A crucial aspect of this process is the strict adherence to the will’s provisions, ensuring that assets are distributed exactly as specified without deviation. Every action taken by the executor must not only follow the directives of the will but also comply with applicable New York state laws. When discrepancies or ambiguities arise, adjustments must be made through legal channels to maintain the process’s legitimacy.

In such a regulated environment, the guidance of a seasoned attorney from Schlessel Law PLLC on Long Island can prove invaluable. Our attorneys are adept in New York estate laws, offering critical advice to ensure accurate execution and compliance with legal standards. We can assist executors in interpreting the will correctly, managing assets efficiently, and making necessary adjustments through appropriate legal procedures. We can assist in maintaining the integrity of the estate administration process and in supporting executors in fulfilling their duties while upholding the decedent’s final wishes. For tailored legal assistance, contact our office today at (516) 574-9630.

from Schlessel Law https://www.schlessellaw.com/can-an-executor-decide-who-gets-what/