Elder Law & Medicaid Long-Term Care Planning
As loved ones age, families are often faced with urgent questions about long-term care, Medicaid eligibility, and how to protect the assets they’ve worked a lifetime to build. At Angiuli & Gentile, LLP, we help clients make informed, strategic legal decisions about long-term care while preserving their financial security.
From Pooled Income Trusts to spousal refusal, we implement sophisticated planning strategies that support aging in place, nursing home care, or assisted living—without sacrificing what matters most.
What Is Managed Long-Term Care (MLTC)?
Managed Long-Term Care (MLTC) is a specialized New York Medicaid program designed to provide long-term services to adults with chronic illness or disability. Through MLTC, eligible individuals receive care such as:
- Home health aides
- Adult day care
- Nursing services
- Personal care
- Care management
However, qualifying for MLTC involves strict financial and medical eligibility requirements, and the application process can be confusing without legal guidance.
Who Qualifies for MLTC in New York?
You may be eligible for MLTC in New York if you:
- Are 21 years or older
- Are Medicaid eligible
- Need long-term care services for at least 120 days
- Live in a county where MLTC is mandatory
- Complete a Conflict-Free Evaluation through the NY Independent Assessor (NYIA)
Even if you meet these requirements, legal planning may be necessary to ensure you don’t jeopardize eligibility due to excess income or assets.
Legal Planning Services We Provide
At Angiuli & Gentile, LLP, our elder law attorneys provide comprehensive legal planning to help you qualify for MLTC and safeguard your financial future.
Medicaid Eligibility and Application Support
- Determining financial eligibility
- Structuring assets and income to meet limits
- Preparing and filing Medicaid and MLTC applications
Income Protection Through Pooled Income Trusts
- Setting up and managing Pooled Income Trusts for excess monthly income
- Coordinating with trust administrators
- Ensuring compliance with Medicaid guidelines
Asset Preservation and Spousal Protection
- Implementing spousal refusal strategies
- Transferring assets safely without incurring penalties
- Drafting Medicaid-compliant trusts
Pre-Application Legal Steps
- Reviewing the five-year lookback rule (where applicable)
- Advising on proper documentation for past financial activity
- Counseling on advance directives and powers of attorney
Help With Medicaid Denials and Fair Hearings
- Appealing MLTC denials
- Preparing clients for NYS Medicaid fair hearings
- Addressing documentation or eligibility disputes
Why Legal Planning Matters
Medicaid eligibility is not just a financial issue—it’s a legal one. Without proper legal guidance, you could:
- Be denied vital home care or nursing services
- Lose assets unnecessarily
- Face delays in care due to application mistakes
- Incur transfer penalties from misunderstood gifting rules
- Miss out on income protection strategies
Our attorneys ensure you avoid these risks through careful, customized planning.
What Is a Pooled Income Trust and Why Do You Need One?
If your monthly income exceeds the Medicaid limit, a Pooled Income Trust allows you to remain eligible for Medicaid while using excess income to pay for living expenses. These trusts are legally recognized in New York and commonly used for community Medicaid recipients.
We assist clients by:
- Explaining trust eligibility
- Setting up and funding the trust
- Coordinating with third-party administrators
- Ensuring that income is deposited properly each month
What Is Spousal Refusal?
Under New York Medicaid law, a spouse can legally refuse to contribute to the cost of care for their partner. This strategy, known as spousal refusal, is a powerful tool that:
- Allows the well spouse to preserve income and assets
- Accelerates Medicaid eligibility for the spouse needing care
- Requires careful legal documentation to be effective
Our firm handles all aspects of spousal refusal filings, ensuring your rights are protected and your financial goals are met.
Understanding the Lookback and Spend Down Rules
While there is currently no lookback period for community Medicaid in New York (as of 2025), changes may occur in the near future. It’s important to:
- Avoid gifts or asset transfers that could result in penalties
- Plan ahead for future nursing home or institutional care, which does have a five-year lookback
- Use legal spend down strategies to reduce countable assets
Our attorneys stay up to date on the latest Medicaid rules to ensure your plan remains compliant and effective.
Documents You May Need When Applying for Medicaid or MLTC
Gathering the right documentation is essential for a successful application. Common documents include:
- Proof of age and residency
- Bank statements (3–6 months)
- Income verification (pension, Social Security, etc.)
- Deeds and mortgage statements
- Medical assessments and care needs reports
- Power of attorney and advance directives
We help clients organize and submit all required documents to avoid processing delays.
Common Medicaid Planning Mistakes to Avoid
- Transferring assets without legal advice
- Waiting too long to plan for long-term care
- Failing to use available income exemptions
- Choosing the wrong MLTC plan
- Not appealing denied applications
- Assuming Medicare covers long-term care (it doesn’t)
Avoiding these mistakes starts with working with experienced legal professionals who understand Medicaid’s complex regulations.
Frequently Asked Questions
Do I need a lawyer to apply for MLTC or community Medicaid?
While not legally required, an attorney ensures your application is accurate and optimized. Mistakes or omissions can result in costly delays or denials.
Can I protect my parent’s home if they apply for Medicaid?
Yes. With proper legal planning, the home can often be protected from estate recovery and eligibility consequences.
How much income can a person keep on Medicaid in NY?
In 2025, the limit is approximately $1,677/month for a single individual. Excess income may be protected using a Pooled Income Trust.
What if we already transferred assets to family members?
Past transfers can be problematic, depending on timing and amount. We will review your case to determine next steps.
Why Choose Angiuli & Gentile, LLP?
Over 40 Years of Trusted Legal Service
Angiuli & Gentile, LLP has been serving Staten Island families for more than four decades, providing reliable and results-driven legal support in elder law and Medicaid planning.
Deep Knowledge of Elder Law and Medicaid
Our team has in-depth, up-to-date knowledge of New York’s complex Medicaid and Managed Long-Term Care (MLTC) systems. We understand the legal strategies that work—and how to use them to your advantage.
Personalized, Compassionate Approach
We treat every client like family. Our attorneys take time to understand your situation, explain your options clearly, and create a customized legal plan that aligns with your personal and financial goals.
Strong Professional Network
We work closely with a network of care providers, Pooled Income Trust administrators, caseworkers, and community resources to ensure seamless coordination and support throughout the planning and application process.
Proven Success with Medicaid Appeals
If you’ve been denied MLTC or Medicaid services, we’re ready to advocate for you. Our attorneys have extensive experience representing clients in fair hearings and appeals, helping them get the care they need when it matters most.
Full-Service Long-Term Care Planning
From the first consultation to post-approval support, we guide families through every stage of Medicaid and elder care legal planning. Our goal is to make a difficult process clearer, safer, and more manageable—so you can focus on what matters most.
Contact Angiuli & Gentile, LLP Today
Whether you’re planning for the future or facing an immediate long-term care crisis, we’re here to help. Early legal intervention is key to preserving assets and securing the care your loved one needs.
Contact Angiuli & Gentile, LLP today to schedule a consultation with a dedicated elder law and Medicaid planning attorney. We proudly serve clients in Staten Island, Brooklyn, and throughout New York City.
