If a New York senior is in immediate need of close, skilled, long-term care and lacks the resources to pay the (quite high) fees for such care are out of pocket, then the only recourse is usually the New York Medicaid system.
But far too many residents fail to appreciate the basic details of this system until they are confronted with the reality head-on. Most notably, Medicaid, unlike Medicare, is based on need–not age. Therefore, the only way to qualify is to have a set asset level that falls below a certain threshold. Many families who have spent a lifetime saving and investing in their home have assets above that threshold. Therefore they are forced to spend down their resources in order to qualify for needed Medicaid support.
A New York Times story from last month discussed how many elderly couples in the past were essentially forced into poverty in order to receive Medicaid help. One story from the 1980s is shared involving a couple who were married for 45 years before divorcing in the mid-1980s. The divorce was not pursued because the couple had fallen out of love, but because it was the only way to avoid the healthier partner from being forced into poverty to ensure the couple qualified for Medicaid.
Fortunately, New York couples now have options to secure necessary long-term care without giving everything away. Most notably, the story notes how federal rules include “spousal refusal” laws which prevent complete poverty by guaranteeing healthy spouses in these settings a certain income. That income is modest, from roughly $2,000 to $3,000 per month. In addition a certain set of assets can be saved by the healthy spouse.
The NYT story also notes that trusts are actually the most efficient way to ensure loved ones receive necessary support while preserving as much family wealth as possible. Importantly, Medicaid Asset Protection Trusts (MAPTs) allow the most flexibility savings. The article notes that it is best to have the help of attorneys on matters of this nature, but, in the end, the savings are certainly worth securing professional support.
With trusts, assets can be transferred to separate entities. If created early enough those assets are protected and not counted in the “spend down” requirement which affected so many families in the past. The ultimate result is that necessary long-term care can be secured without sacrificing a family’s life savings.
For help navigating the complex New York Medicaid system, feel free to reach out to our elder law attorneys today for tailored guidance.