Medicaid Planning
Navigating long-term care for a parent or spouse is emotionally taxing and financially overwhelming. At Angiuli & Gentile, LLP, we guide families through the legal complexities of Medicaid planning with empathy, clarity, and more than 30 years of elder law experience. Our Staten Island-based law firm helps seniors qualify for Medicaid while legally preserving assets, income, and the family home.
We work with both proactive families looking to plan in advance and those in urgent situations who need emergency solutions. Our Medicaid planning services are tailored to the specific circumstances of each client, ensuring compliance with New York State Medicaid rules and delivering peace of mind during life’s most difficult transitions.
What Is Medicaid Planning?
Medicaid planning is the process of preparing a person’s financial and legal affairs to qualify for Medicaid without exhausting personal savings or losing important assets like the family home. It involves using lawful strategies such as trusts, annuities, exemptions, and spend-down planning to bring income and assets in line with eligibility limits.
Unlike Medicare, Medicaid pays for long-term care, including nursing homes, home care, and assisted living — but only if you meet strict financial criteria. Without proper planning, seniors may be forced to sell their assets or be denied care at a critical time.
Medicaid planning helps:
- Qualify for care benefits sooner
- Avoid unnecessary penalties during the look-back period
- Protect property and retirement assets
- Ensure spouses and dependents are not left financially vulnerable
The High Cost of Long-Term Care in New York
Long-term care is one of the biggest threats to a family’s financial security. According to the New York Department of Health:
- The average cost of a nursing home exceeds $12,500 per month
- Assisted living facilities in NYC can cost $6,000–$8,000 per month
- In-home care averages over $30 per hour
Few families can sustain these costs without assistance. Medicaid is often the only solution — but accessing it without preparation can create severe consequences, including denied coverage or forced liquidation of family assets.
Our Medicaid planning services are designed to avoid these outcomes and provide a clear path forward.
Who Needs Medicaid Planning?
Medicaid planning isn’t just for the wealthy — or the poor. It’s for:
- Middle-class families concerned about losing savings to nursing homes
- Adult children responsible for aging parents’ care
- Healthy seniors who want to prepare early
- Married couples with one spouse needing long-term care
- Families with disabled children or dependents needing protection
Whether you’re looking ahead or responding to a recent diagnosis or care need, we can help.
New York Medicaid Eligibility Requirements (2025)
To qualify for Medicaid long-term care, an individual must meet both income and asset thresholds. These rules vary by state and change annually.
Financial Limits for 2025
Single Applicant:
- Income limit: $1,800/month
- Asset limit: $32,396.00
Married Couple (one spouse applying):
- Community Spouse Resource Allowance: Up to $74,820 (or the spousal share of 1/2 combined resources up to a maximum of $157,920)
- Community Spouse Monthly Income Allowance: $3,948.30/month
Countable Assets:
- Cash, checking/savings accounts
- Retirement accounts (IRAs, 401(k)s) THAT ARE NOT IN PAYOUT STATUS
- Investments and brokerage accounts
- Real estate other than your primary home
Exempt Assets:
- Primary residence (up to an equity limit)
- One car
- Personal belongings and household items
- Irrevocable Funeral Arrangements
Our attorneys will assess your full financial picture and categorize assets properly, helping you avoid unnecessary disqualifications or penalties.
Medicaid’s Look-Back Period: What You Must Know
The 5-year look-back rule is one of the most misunderstood—and dangerous—aspects of Medicaid law.
When you apply for Medicaid long-term care benefits, the state will review all financial transactions made in the 60 months prior to the application date. Any transfers made for less than fair market value (such as gifts or quick property transfers) may result in a penalty period of ineligibility, meaning you’ll have to pay for care out-of-pocket during that time.
What Triggers a Penalty?
- Gifting money to children or grandchildren
- Transferring a home title to family
- Selling property below market value
- Depositing large cash sums without documentation
Our attorneys will examine your transfer history and recommend corrective measures, such as returning assets, converting them, or using exempt transfer rules that avoid penalties.
Legal Tools We Use to Protect Assets
We don’t believe in one-size-fits-all solutions. We design personalized strategies using a range of Medicaid-compliant tools.
Irrevocable Medicaid Trusts
This is the cornerstone of many long-term plans. By transferring assets into an irrevocable trust, seniors can retain use and income while ensuring the principal is not countable for Medicaid purposes—so long as the trust is established and funded more than five years before applying.
Medicaid-Compliant Annuities
These are used in crisis situations when planning ahead wasn’t possible. A Medicaid-compliant annuity turns excess assets into a structured income stream that does not count toward eligibility.
Spend-Down Strategies
Spend-down doesn’t mean wasting money. We help clients reduce countable assets by paying for exempt items and allowable services, such as:
- Home renovations for medical accessibility
- Paying down debts
- Prepaid Irrevocable burial arrangement
- Medicaid fair hearings
- Upgrading household furnishings or a car
Life Estate Deeds and Home Transfers
We protect the family home using legal transfer techniques, such as:
- Life estate deeds (retains lifetime use)
- Caregiver child exemption transfers
- Spousal and sibling exemptions
- Trust ownership
Medicaid Planning for Married Couples
When one spouse enters long-term care, the other may be at risk of losing income or assets. Medicaid offers specific protections, but they’re not automatic.
Our Services Include:
- Calculating the Community Spouse Resource Allowance (CSRA)
- Structuring annuities for the healthy spouse
- Using spousal refusal strategies when appropriate
- Petitioning the court for fair income allowances
Our team helps ensure that the spouse remaining at home is not left impoverished, and that the family’s wealth is legally preserved.
Emergency Medicaid Planning: It’s Not Too Late
Many families come to us in a crisis — a parent has entered a nursing home, the savings are nearly gone, and the Medicaid application is looming.
Even in these scenarios, we can still help.
Through emergency planning techniques, we may be able to:
- Convert assets quickly
- Protect the home from recovery
- Reduce or eliminate look-back penalties
- Secure Medicaid coverage faster than expected
If your loved one is already receiving care, contact us immediately — time matters.
Why You Need a Medicaid Planning Attorney
The Risks of Going It Alone
The Medicaid application process is long, confusing, and unforgiving. Mistakes — even honest ones — can delay benefits or cost tens of thousands of dollars. Relying on online templates, non-lawyer “planners,” or outdated advice puts your family at risk.
The Value of Working with Angiuli & Gentile, LLP
Our team offers:
- Over 30 years of elder law experience
- Mastery of New York Medicaid laws
- Fully customized plans for each family
- In-depth financial reviews and guidance
- Ongoing legal support through the application process
You’ll never be left wondering if you made the right decision — we walk with you from start to finish.
Common Medicaid Planning Mistakes to Avoid
- Waiting too long to start planning
- Giving away money during the look-back window
- Failing to use trusts properly
- Naming the wrong beneficiaries
- Filing applications with incorrect documentation
- Assuming Medicare covers long-term care (it doesn’t)
We’ll help you spot these pitfalls before they cost your family valuable time and resources.
Frequently Asked Questions (FAQs)
Can Medicaid take the family home after my parent passes?
Yes, Medicaid can pursue estate recovery—but this is avoidable with proper planning, such as placing the home in an irrevocable trust.
We transferred assets recently. Are we disqualified?
Not necessarily. Transfers within five years may trigger a penalty period, but corrective strategies are often available to minimize or remove this.
My parent is already in a nursing home—can we still plan?
Yes. Emergency Medicaid planning is possible and often very effective. Timing is critical, so contact our office right away.
Do I really need a lawyer to apply for Medicaid?
Yes. Medicaid laws are complex, and the cost of errors can be significant. An experienced elder law attorney ensures your plan is legal, strategic, and effective.
Why Clients Trust Angiuli & Gentile, LLP
Decades of Dedicated Experience
With over 30 years of focused legal practice in elder law and Medicaid planning, Angiuli & Gentile, LLP has become a trusted partner to families throughout Staten Island and the greater New York City area. Our attorneys bring not only deep legal knowledge but also the sensitivity and perspective that come from helping hundreds of clients navigate some of life’s most difficult transitions.
In-Depth Knowledge of New York Medicaid Rules
Medicaid planning is not one-size-fits-all—and laws vary by state. Our firm stays up-to-date with New York-specific Medicaid regulations, income limits, asset rules, and spousal protections to ensure that every strategy we create is fully compliant and highly effective.
Customized Legal Strategies for Every Family
We understand that no two families are alike. Whether you’re protecting a home, preparing for nursing care, or balancing the needs of multiple generations, we take the time to understand your circumstances and develop a personalized plan that reflects your goals, assets, and timeline.
Compassionate Communication and Guidance
Legal planning for a loved one’s care can be emotionally overwhelming. That’s why our attorneys prioritize clear, empathetic communication. We explain your options in plain language, outline every step of the process, and provide honest answers to all your questions—without judgment or pressure.
Ongoing Support at Every Stage
Medicaid planning doesn’t end after a single meeting. We support our clients through every stage, from trust creation and spend-down planning to application filing, appeals, and post-approval considerations. Our team remains available to you long after the initial plan is in place.
More Than Legal Counsel—We’re Your Advocates
When you choose Angiuli & Gentile, LLP, you’re gaining more than legal representation. You’re partnering with a team that understands your family’s needs, respects your values, and is committed to helping you protect what matters most. We advocate for your financial well-being, your dignity, and your peace of mind—every step of the way.
Contact Angiuli & Gentile, LLP Today
Don’t wait until a crisis forces your hand. Early planning creates more options and greater protection. Whether you’re preparing years in advance or dealing with an immediate care issue, our team is ready to help.
Contact Angiuli & Gentile, LLP today to schedule your consultation.
