Elder Law Is for Everyone Part 1: Long-Term Care Planning

Notwithstanding the concept of a “youth culture,” we all want the chance to grow old and live life on our terms, which takes thoughtful planning. Elder law planning is as important as having a healthy lifestyle and planning for retirement.

Elder law planning combines traditional estate planning, planning to maintain control of financial and personal decision-making, and long-term care planning to reduce the risk of financial ruin from long-term care costs. The average 2025 Long Island monthly nursing home cost $14,914. Home care costs range between $25 and $35 per hour.

One aspect of long-term care planning addresses how care will be financed. In New York, there are three ways to pay for long-term care (1) private payment (2) long-term care insurance benefits (3) New York community-based or institutional Medicaid.

Long-term care policies begin paying benefits when the policyholder meets the policy requirements. Traditional policies pay a defined benefit for long-term care; the policy ends once the policy  term or the benefit cap is reached. At the end of a traditional policy, the policyholder returns to private payment. New York State Partnership policies combine traditional policies and Medicaid. Partnership policies pay insurance benefits for the insurance term like a traditional policy. Generally, once the insurance term expires, the policyholder is eligible for New York Medicaid, even if  they may have assets above the Medicaid eligibility standard.

Medicaid eligibility is based on income, assets and non-exempt asset transfers during the lookback period. The nursing home lookback period is five years; penalties for asset transfers don’t begin until the applicant’s non-exempt assets are $32,396 or less. Community spouses can have between $74,820 to $157,920 of non-exempt assets.

The Medicaid income limits are different for homecare and nursing homecare. New York does not have an income cap, and excess income can be spent on healthcare expenses. Assets transferred to a properly drafted and administered irrevocable “Medicaid trust” beyond the lookback are not available for Medicaid eligibility purposes.

Long-term care is expensive. Not everyone is eligible for or can afford long-term care insurance. The Medicaid rules are complicated. A caring, experienced elder law attorney can help implement a plan that ensures your quality of life and financial well-being.

This article appeared in the August 2025 issue of Stroll Lloyd Harbor.