As of 2024, the estimated average nursing home rate in New York City was reported at $469 per day, or $171,276 per year. Given your current state of health and other extenuating circumstances, residing in a nursing home facility may work in your best interest. However, you may fear that, in the process, you may lose a significant portion of the assets you wanted to pass down to your loved ones. Well, for this reason, we encourage you to look into the federal Medicaid program, along with utilizing other helpful estate planning tools. Please read on to discover whether you can pay for your nursing home expenses through the Medicaid program and how a seasoned New York City asset preservation attorney at Mark Wakim Law, can help ensure your eligibility.
Can I pay for my nursing home costs through Medicaid?
First of all, you should know that Medicaid is not made available for everyone, but rather, you must qualify for it. Specifically, you must either be disabled, blind, or 65 years old or older. Then, as of 2024 in New York State, you must earn less than $1,732 in monthly income, or $2,351 per month if both you and your spouse are applying.
Lastly, Medicaid may only cover your nursing home costs if you can prove that your medical condition is serious to the point that having access to skilled care made only available at a nursing home facility is medically necessary. To confirm this, an evaluator may visit you at your nursing home and review your medical condition, along with your ability to perform certain tasks (i.e., eating, moving around, using the bathroom, etc).
If you hit all these marks, Medicaid may offer coverage for the following expenses associated with your nursing home stay:
- The cost of your room and board.
- The cost of your necessary nursing care.
- The cost of your necessary personal care assistance.
- The cost of your appointments with a treating physician.
- The cost of your prescription medications.
- The cost of your prescribed mental health counseling sessions.
- The cost of your social activities and programs at the facility.
How can I eventually become eligible for the Medicaid program?
While you may meet the medical eligibility requirements for the Medicaid program, your financial standing may be above the imposed limit. Well, you should know that New York State offers something known as the Excess Income Program. With this, you may subtract your monthly, qualifying medical expenses from your monthly income to better meet the Medicaid income limits. For example, say you earn $2,000 per month, but your medical care costs $400 per month. Well, your countable income may be considered $1,600 per month, which is below the $1,732 per month cap.
If this does not work, estate planning tools are also at your disposal, specifically an irrevocable trust. Here, you may transfer your ownership over certain assets to the trust, thus reducing your countable assets. In doing so, though, you must be careful with Medicaid’s five-year look-back period. This is because the New York State Medicaid agency may investigate any asset transfers you made in the five years immediately before your application submission. And if they find the establishment of your irrevocable trust was too recent, they may delay your eligibility for the program.
We understand just how overwhelming all of this can be for you. So, if you have any remaining questions, please consult with a competent New York City estate planning attorney. The team at Mark Wakim Law, is willing and able to provide you with legal assistance in any capacity.
