Medicaid Planning Attorney in Brooklyn & NYC

Medicaid planning in New York starts with knowing which kind of long-term care coverage a family may need. Schwartsman Law Group PLLC helps families in Brooklyn, across New York City and on Long Island prepare for Medicaid eligibility, both for nursing home care and for care at home. We are licensed to practice law in New York only. Call (212) 518-3868 or request a Free Consultation.

Community Medicaid vs. nursing home Medicaid

Families often talk about Medicaid as if it were one program. We plan separately for community-based long-term care (care at home or in the community) and institutional (nursing home) care, because the look-back rules for the two are not the same.

• Community-based long-term care. Many families first look into Medicaid when a parent needs help at home. We review the family's finances and records with that application in mind.
• Nursing home care. When facility care is needed, the 60-month look-back applies. That makes the timing of the application, and any earlier transfers, central to our review.

Many families start with home care and later need a nursing home. A plan built only for a home care application can cause problems if a nursing home application follows within five years. We plan with both paths in mind from the first meeting.

Look-back periods at a glance

Type of coverage	Look-back status today	What it means in practice
Nursing home (institutional) Medicaid	60 months (five years): in effect	Asset transfers made within the 60-month look-back may trigger a transfer penalty.
Community-based long-term care	30 months: in state law subject to federal approval, but not in effect	The 30-month community look-back is not in effect. This could change if the rule is approved and implemented.

Do not read this contrast as a loophole. A transfer made today still falls inside the 60-month nursing home look-back if facility care is needed later.

The five-year look-back for nursing home care

New York Social Services Law §366(5)(e) sets the look-back for institutional care at 60 months. Federal law, 42 U.S.C. §1396p(c)(1)(B), uses a 60-month look-back for trust-related disposals and for other asset disposals made on or after February 8, 2006. Under that federal provision, the 60 months run back from the relevant application/institutionalization date. Transfers made within that window may trigger a transfer penalty.

• Disposals involving a trust, including an irrevocable trust, fall within the 60-month look-back. Using a trust does not take a transfer outside it.
• We review account records for the full period to find gifts, transfers and large withdrawals. We help families gather explanations before an application is filed.

This is why early planning, including a Medicaid Asset Protection Trust (MAPT), is different from crisis work after a hospital discharge. The earlier a plan is in place, the more room a family usually has on timing.

Where the 30-month community look-back stands

Social Services Law §366(5)(e) contains a 30-month look-back for community-based long-term care, but it is expressly subject to federal approval. As part of the Medicaid Redesign Team II (MRT II) initiative, the Department of Health (DOH) asked federal regulators to approve a Section 1115 waiver amendment. The amendment would impose a 30-month look-back on people living outside institutions who seek coverage of community-based long-term care. The State first planned to start on January 1, 2021. Its official proposal page now says that, because of federal pandemic-era and home-care funding requirements, the earliest date it would seek implementation is March 31, 2024.

As of November 2026, we have not found a DOH implementation directive or a confirmed federal approval. The 30-month community look-back is not in effect.

Two cautions follow. First, a gift made today to qualify for home care still falls inside the 60-month nursing home look-back. Second, the community rule could take effect once federal approval and state directives are issued. We follow DOH guidance and update our advice when the rules change.

Reviewing the home and other assets

A home is often a family's largest asset and its most personal one. Before we advise on a home, we review how it is titled, any mortgages or liens, who lives there, and the family's long-term wishes for the property. We check the DOH guidance that applies to the family's situation instead of relying on general assumptions.

We do the same for every other asset, including bank and brokerage accounts, retirement accounts, life insurance and vehicles. We list and review each asset before recommending any transfer or retitling.

Medicaid Asset Protection Trusts (MAPTs)

A MAPT is an irrevocable trust used in long-term Medicaid planning. Transfers into it fall within the 60-month look-back, so timing is central. When we design one, we go over these points with the client:

• Who will serve as trustee
• Who the beneficiaries will be
• Which assets are suitable to place in the trust
• How the trust fits with the client's will, powers of attorney and tax planning

Formal requirements matter. Under EPTL 7-1.17, a New York lifetime trust must be in writing. It must be executed and acknowledged by the creator and at least one trustee (unless the creator is the sole trustee), or executed before two witnesses. Amendments follow the same rules. Under EPTL 7-1.18, the trust is valid only to the extent assets are actually transferred into it. A statement in the trust document that an asset belongs to the trust is not a transfer. We help clients complete the deeds and account retitling needed to fund the trust.

MAPTs are planning tools, not guarantees. Moving assets into the trust falls within the nursing home look-back, and the details of drafting and funding matter. We coordinate the MAPT with wills, powers of attorney and tax issues so the estate plan still works if Medicaid is never needed.

Spousal impoverishment protections (2026 figures)

Sometimes one spouse needs nursing home care while the other stays at home (the "community spouse"). New York Social Services Law §366-c sets out how a community spouse resource allowance and a minimum monthly maintenance needs allowance are calculated. The 2026 figures, effective January 1, 2026, come from DOH GIS 26 MA/03:

• Maximum federal Community Spouse Resource Allowance (CSRA): $162,660
• Minimum state Community Spouse Resource Allowance: $74,820
• Community spouse Minimum Monthly Maintenance Needs Allowance (MMMNA): $4,066.50 per month

The resource allowance falls between the state minimum and the federal maximum. The exact amount depends on the couple's resources and the §366-c calculation. Under the MMMNA, if the community spouse's own income is below $4,066.50 per month, part of the other spouse's income may be allocated to make up the difference.

These figures are updated each year. We run the numbers against the current DOH and federal standards before recommending any transfer, retitling or other step.

Pooled trusts and supplemental needs trusts

Federal and New York law recognize certain trusts for people with disabilities. A pooled trust under 42 U.S.C. §1396p(d)(4)(C) and Social Services Law §366(2)(b)(2)(iii)(B) holds the assets of a disabled individual. It is established and managed by a nonprofit association. The trust keeps a separate account for each beneficiary but pools the accounts for investment and management. Accounts are established only for the benefit of individuals who are disabled. We review whether a pooled trust fits a client's situation and help with the paperwork the nonprofit requires. See our overview of pooled trusts and NY community Medicaid.

The law also recognizes a first-party supplemental needs trust holding the assets of a disabled person under 65. It may be set up by the individual, a parent, a grandparent, a legal guardian or a court. When the beneficiary dies, the State receives what remains in the trust, up to the total medical assistance paid. These trusts can be valuable after a settlement or an inheritance.

Crisis planning

A care crisis does not always mean nothing can be done. When care is needed now, we review the family's facts, including marital status, the types of assets involved, past transfers and the timing of the application. Then we explain the options we see. These situations are technical, and the order of steps matters. Planning well ahead usually gives a family more room.

Documentation and the application process

We help families gather the kinds of records that Medicaid applications commonly call for, such as:

• Bank and brokerage statements
• Proof of income
• Life insurance policy information
• Deeds and vehicle titles
• Explanations of large withdrawals or transfers

For a nursing home application, we organize records with the full 60-month look-back in mind. An incomplete packet can slow things down, so we prepare organized submissions and answer follow-up requests for documents.

Medical and care needs are part of the picture too. We work with the family and its care providers so the financial and care planning move together.

Medicaid planning across New York City and Long Island

We advise families throughout the five boroughs and on Long Island. For local information, see our pages on Brooklyn Medicaid planning, Manhattan Medicaid planning, Queens Medicaid planning, Bronx Medicaid planning, and Long Island Medicaid planning.

How Schwartsman Law Group helps

From our Brooklyn office, we serve clients across New York City and Long Island. We:

• Review income, assets, deeds and beneficiary designations with current New York Medicaid rules in mind
• Design and fund MAPTs and related estate planning documents when timing allows
• Prepare and support nursing home and community Medicaid applications
• Advise on pooled trusts, supplemental needs trusts, spousal allowances and look-back exposure
• Coordinate Medicaid planning with estate planning, probate, and guardianship when a family needs more than one court or agency process

Next steps

Please bring the following to your consultation:

• A list of assets and income
• The deed to any real property
• Any existing wills, trusts, powers of attorney and health care proxies
• Long-term care insurance information, if you have it
• A note of any significant gifts or transfers made in the last five years

We will explain where you stand under current New York rules and how the look-back may affect timing. Call (212) 518-3868 or request a Free Consultation using the form below.