Medicaid Community Spouse Planning
What Is Medicaid Community Spouse Planning?
Medicaid community spouse planning is a specialized legal process designed to protect the financial well-being of the “community spouse” — the healthy spouse who remains at home — when their partner requires long-term care in a facility covered by Medicaid.
Without proper planning, the community spouse may be left with little to no income or assets, even though they’re not the one receiving care. Our attorneys work to ensure that both spouses remain financially stable while meeting Medicaid’s complex eligibility requirements.
Why Married Couples Need Medicaid Planning
Medicaid Counts Assets and Income Jointly
When one spouse applies for Medicaid, the government doesn’t just look at their individual finances — they evaluate the couple’s joint assets and income. That means even if only one spouse is going into a nursing home, both spouses’ resources are at risk.
Risk of Financial Devastation Without Planning
Without Medicaid planning, families often make critical mistakes — such as giving away assets too late, misunderstanding eligibility rules, or assuming they must “spend down” everything. This can result in:
- Unnecessary depletion of life savings
- Loss of the family home
- Denial of Medicaid eligibility
- Delayed care for the spouse in need
We help you avoid those risks — legally, efficiently, and with compassion.
Understanding the Role of the Community Spouse
Who Is the Community Spouse?
The community spouse is the healthy spouse who continues living at home while their partner resides in a long-term care facility. This spouse still needs income, housing, and access to essential resources.
Legal Protections for the Community Spouse
Federal and state laws offer key financial protections for the community spouse — but only if those rules are applied correctly. These protections include:
- The Community Spouse Resource Allowance (CSRA)
- The Minimum Monthly Maintenance Needs Allowance (MMMNA)
- Exempt assets (like your home, car, and some retirement accounts)
Proper legal guidance ensures these allowances are maximized and assets are preserved.
Key Medicaid Terms You Should Know
Community Spouse Resource Allowance (CSRA)
The CSRA allows the community spouse to keep a portion of the couple’s assets without affecting the other spouse’s Medicaid eligibility. For 2025 in New York, that amount is $154,140. However, understanding what counts as an asset — and how to legally structure or transfer it — is critical.
Minimum Monthly Maintenance Needs Allowance (MMMNA)
The MMMNA protects the community spouse’s income by ensuring they receive a minimum monthly income, even if that income must be transferred from the institutionalized spouse. In 2025, the MMMNA in New York is approximately $3,853.50, but this may vary based on living expenses.
Medicaid Spend-Down and the Look-Back Period
If a couple’s assets exceed Medicaid’s limits, they may need to “spend down” to qualify. However, improper transfers during the five-year look-back period can trigger penalties and delays. Our attorneys help you navigate this process carefully and legally.
Strategies to Protect the Community Spouse
1. Medicaid Asset Protection Trusts (MAPTs)
A MAPT allows you to transfer assets — such as your home or investments — into an irrevocable trust that removes them from Medicaid’s countable asset pool after the 5-year look-back period. This is one of the most powerful tools for long-term asset protection.
2. Medicaid-Compliant Annuities
These annuities convert excess assets into an income stream payable to the community spouse. When structured properly, this income does not count against Medicaid eligibility, helping preserve large portions of your savings.
3. Spousal Refusal (Unique to New York)
New York law allows a community spouse to formally refuse to contribute to their spouse’s care, even while retaining their own assets. This can accelerate Medicaid approval, though it may trigger cost-recovery attempts. We guide you through this complex but often effective tactic.
4. Strategic Spend-Down Planning
Instead of simply “spending” assets, we help you spend intelligently — on exempt items like:
- Home improvements
- Paying off a mortgage
- Purchasing a vehicle for the community spouse
- Prepaying funeral expenses
These strategies preserve value while moving you closer to eligibility.
Real Case Example: A Staten Island Couple Avoids Financial Loss
A Staten Island couple in their 70s came to us after the husband was diagnosed with Alzheimer’s and required full-time care. With nearly $400,000 in savings and a home they had lived in for decades, they were terrified they’d lose everything.
We implemented a Medicaid Asset Protection Trust for their home, structured a Medicaid-compliant annuity, and used a spousal refusal strategy. The result: the wife kept the home, retained most of their savings, and the husband qualified for Medicaid within months — no spend-down necessary.
New York Medicaid Updates for 2025
Here are the most important updates to know:
- The CSRA (amount the community spouse can keep) is now $154,140
- The MMMNA (protected monthly income) is approximately $3,853.50
- The institutionalized spouse can retain $30,182 in personal assets
- The look-back period for nursing home Medicaid remains 60 months
- Home care look-back expansion is expected but not yet active in all counties
Our team stays fully informed and adjusts your plan as policies evolve.
Why Early Planning Is Critical
The 5-Year Advantage
Planning five years before a Medicaid application allows you to use trusts and transfers without penalty. If you plan early, your options expand, and your protections increase.
Benefits of Planning Ahead
- Avoid Medicaid transfer penalties
- Preserve your home from estate recovery
- Maximize income and resource allowances
- Secure long-term financial peace for your spouse
Whether you’re decades from needing care or already facing nursing home costs, now is the time to plan.
Our Legal Process: What to Expect
Step 1: Personal Consultation
We listen to your concerns, review your assets, and identify your planning goals.
Step 2: Asset & Income Analysis
We evaluate what can be protected, what may be at risk, and what options are available under current law.
Step 3: Customized Planning
We design a tailored legal strategy using the best tools for your unique situation.
Step 4: Legal Implementation
We draft trusts, handle asset transfers, and file all Medicaid applications as needed.
Step 5: Ongoing Support
We offer updates, annual reviews, and ongoing legal help as rules change or your needs evolve.
Why Choose Angiuli & Gentile, LLP?
Choosing the right law firm for Medicaid and elder law planning can make all the difference in protecting your future. At Angiuli & Gentile, LLP, we bring decades of experience, legal precision, and a human touch to every case.
Over 30 Years of Experience in Elder Law
For more than three decades, our attorneys have helped New York families navigate the complexities of Medicaid planning, long-term care, and elder law. We know the system inside and out — and we know how to make it work for you.
Deep Knowledge of New York-Specific Medicaid Strategies
Medicaid rules vary by state, and New York has its own unique policies, exceptions, and planning tools. Our firm stays up-to-date on all local legislation and uses state-specific strategies to ensure compliance while protecting your assets.
Compassionate and Personalized Legal Support
Every family has a unique story. We listen first, then build a plan around your values, your goals, and your life. Our clients never receive “cookie-cutter” documents — just clear, thoughtful guidance tailored to their needs.
Proven Track Record of Asset Protection
We’ve helped clients preserve their homes, safeguard retirement accounts, avoid spend-downs, and reduce Medicaid penalties. Our results speak for themselves — and so do our long-standing relationships with the families we serve.
Comprehensive Legal Services in One Place
We go beyond Medicaid. From estate planning and powers of attorney to guardianships and probate, we provide end-to-end legal support to secure your family’s future now and in the years to come.
Your Long-Term Legal Partners
At Angiuli & Gentile, LLP, we don’t see our clients as cases — we see them as partners. Whether you need immediate Medicaid planning or want to prepare for what’s ahead, we’re here for the long haul.
Frequently Asked Questions About Medicaid Community Spouse Planning
What is a community spouse?
A community spouse is the healthy spouse who continues living at home while their husband or wife receives long-term care in a facility covered by Medicaid. Although they’re not the one applying for Medicaid, their finances are still affected by Medicaid eligibility rules. Planning is essential to ensure they are not left impoverished.
Will Medicaid take our home if one spouse goes into a nursing home?
No, not while the community spouse is living in the home. Medicaid considers the primary residence an “exempt” asset in this scenario. However, without proper legal planning, the state may attempt to recover the value of the home after both spouses have passed away. A Medicaid Asset Protection Trust can help avoid this.
How much money can the community spouse keep?
In 2025, New York allows the community spouse to retain up to $154,140 in countable assets under the Community Spouse Resource Allowance (CSRA). There are additional rules that allow the community spouse to retain a portion of the institutionalized spouse’s income through the Minimum Monthly Maintenance Needs Allowance (MMMNA).
Do we have to spend down all of our savings to qualify for Medicaid?
No. Many families mistakenly believe they must exhaust their savings to qualify. With the right legal strategy — such as Medicaid-compliant annuities, trusts, or spousal refusal — much of your savings can be legally preserved.
What is the five-year look-back period?
The five-year look-back period is a Medicaid rule that reviews all asset transfers made within the five years prior to your application. If assets were transferred for less than fair market value during this time, Medicaid may impose a penalty period, delaying eligibility. Proper planning helps you navigate or avoid these penalties.
Contact Angiuli & Gentile, LLP Today
Don’t wait for a medical crisis to start planning. Whether you’re preparing early or already facing long-term care decisions, we’re here to help you protect your spouse and secure your legacy. Contact us today to schedule your free consultation.
