Medicaid Pooled Income Trusts for New York Seniors
At Angiuli & Gentile, LLP, we understand how challenging it can be for seniors and their families to navigate the complicated landscape of Medicaid eligibility—especially when an individual’s income exceeds the Medicaid limit. Fortunately, New York State offers a legal and highly effective solution: the Medicaid pooled income trust.
Our elder law attorneys specialize in helping clients use pooled income trusts to legally protect their income while maintaining eligibility for Community Medicaid, which covers essential services like in-home care, home health aides, and adult day programs.
Legal Help for Seniors with Excess Income in New York
Many New Yorkers find themselves in a difficult situation: they earn too much to qualify for Medicaid, yet not enough to afford private care. If you or a loved one is applying for Community Medicaid (the program that helps seniors receive care at home instead of in a nursing facility), this is a common problem.
New York’s Medicaid program sets a strict monthly income limit. Any amount over that limit—known as “excess income”—typically must be spent down on medical expenses before Medicaid will pay for services. However, that spend-down process can leave seniors without the resources they need to pay rent, buy groceries, or cover other essential bills.
That’s where a Medicaid pooled income trust comes in. This specialized legal tool allows you to protect your excess income, pay your monthly expenses, and still qualify for Medicaid.
What Is a Pooled Income Trust?
A pooled income trust is a type of irrevocable trust established and managed by a nonprofit organization. It is specifically designed to help individuals who receive or are applying for Medicaid but whose monthly income is above the allowable limit.
Rather than losing access to Medicaid because of excess income, individuals can deposit that income into a pooled trust. The trust then uses those funds to pay for certain allowable expenses on behalf of the Medicaid recipient.
These expenses typically include:
- Rent or mortgage payments
- Utilities (electric, gas, water)
- Telephone, internet, and cable bills
- Medical bills not covered by Medicaid
- Home care costs not otherwise reimbursed
- Transportation and personal needs
The funds in a pooled trust do not count as available income for Medicaid eligibility purposes, which means you can continue receiving benefits without being forced to spend down your income unnecessarily.
Why Use a Medicaid Pooled Trust?
For seniors and disabled individuals, a pooled income trust is not just a financial workaround—it’s a critical lifeline that allows them to remain in their homes, maintain their quality of life, and still access vital care through Medicaid.
Here are the most common reasons our clients choose to establish a pooled trust:
1. Avoid Medicaid’s Spend-Down Requirement
Without a trust, any income over the Medicaid limit must be spent on medical bills before Medicaid will cover services. This is called the “spend-down.” With a pooled trust, you can legally avoid this spend-down and preserve your income for essential living costs.
2. Stay Eligible for Home Care
Many of our clients use pooled income trusts to qualify for Community Medicaid, which includes home care services. These services allow individuals to age in place, avoid institutional care, and receive the support they need in the comfort of their own homes.
3. Legal and Compliant Income Protection
Pooled trusts are completely legal and are specifically recognized under federal and state Medicaid laws. When properly set up and managed, they offer a Medicaid-compliant way to shelter income while meeting eligibility rules.
4. Preserve Dignity and Independence
Being forced to choose between Medicaid and your basic living expenses can be emotionally devastating. A pooled trust provides peace of mind and financial dignity—so you can keep a roof over your head, pay your bills, and receive the care you need.
Medicaid Income Limits in New York (2025)
As of 2025, the monthly income limit for a single individual applying for Community Medicaid in New York is $1,732. For many seniors, monthly income from Social Security, pensions, or retirement distributions exceeds this amount.
Even exceeding the limit by just a few hundred dollars can disqualify someone from Medicaid coverage. In such cases, New York law permits the use of a pooled income trust to offset the difference, thereby preserving eligibility without having to spend all of your income on medical costs.
Understanding these income thresholds is essential to any Medicaid planning strategy. Our attorneys stay up to date on the annual changes to Medicaid eligibility criteria and guide our clients through all necessary adjustments during recertification.
How to Set Up a Pooled Income Trust in New York
At Angiuli & Gentile, LLP, we offer full-service legal assistance in setting up and managing pooled income trusts. The process may seem complicated, but with experienced legal guidance, it becomes straightforward and manageable.
Here’s how we help:
Step 1: Medicaid Budget Review
We begin by reviewing your Medicaid budget and determining your monthly excess income, which is the amount that must be deposited into the pooled trust each month.
Step 2: Selecting a Trust Administrator
We work with several reputable, nonprofit trust administrators and will recommend one that best fits your needs. The administrator will be responsible for receiving monthly deposits and paying your bills.
Step 3: Legal Document Preparation
Our team prepares the necessary paperwork, including:
- Trust enrollment form
- Medicaid notice of decision
- Proof of income (Social Security statements, pension award letters, etc.)
- Government-issued identification
- Bank information for deposit
Step 4: Submitting the Application and Initial Deposit
We coordinate the submission of your trust documents and the first deposit of excess income. This step is critical to ensure that your Medicaid benefits remain uninterrupted.
Step 5: Monthly Compliance Support
We assist with submitting bills, ensuring monthly deposits are made, and preparing for Medicaid recertification so that your eligibility remains in good standing.
What Can Be Paid Through a Pooled Income Trust?
Funds deposited into a pooled income trust can be used to pay for a wide range of qualifying expenses, including:
- Monthly rent or mortgage
- Condo or co-op fees
- Utility bills (electricity, water, gas, etc.)
- Cable, internet, and phone bills
- Medical bills and co-pays
- Home care services not covered by Medicaid
- Personal items and clothing
- Transportation services
- Insurance premiums
It’s important to note that trust funds cannot be used for gifts, vacations for others, or expenses not directly related to the Medicaid recipient’s needs. We advise clients on allowable expenses and help prevent violations that could trigger a Medicaid penalty.
Who Should Consider a Pooled Income Trust?
A pooled income trust is ideal for:
- Seniors applying for Community Medicaid with income exceeding the eligibility limit
- Disabled individuals receiving SSI or SSDI who also qualify for Medicaid
- Adults requiring home care services but who are just over the income threshold
- Children or caregivers assisting a parent or loved one with long-term care planning
- Individuals seeking to remain independent at home while receiving government-funded care
If you or your loved one falls into any of these categories, establishing a pooled trust can significantly ease financial burdens and enhance access to care.
Why Choose Angiuli & Gentile, LLP?
For more than 30 years, Angiuli & Gentile, LLP has provided trusted legal counsel to individuals and families in Staten Island and throughout New York City. Our elder law team focuses on the unique needs of aging clients and delivers thoughtful, personalized solutions for long-term care planning, Medicaid eligibility, and asset protection.
When you work with us, you gain:
- Dedicated Medicaid planning attorneys with deep knowledge of NYS pooled trust rules
- A seamless, stress-free experience setting up and managing your trust
- A strong network of nonprofit trust administrators to ensure smooth administration
- Ongoing legal support for Medicaid renewals, recertification, and appeals if needed
We take pride in empowering New York seniors to age with dignity, while protecting the financial resources they’ve worked so hard to build.
Common Questions About Pooled Income Trusts
Can I qualify for Medicaid if my income exceeds the limit?
Yes. With a pooled income trust, your excess income is not counted toward Medicaid eligibility.
Who manages the trust?
The trust is administered by a nonprofit organization that handles monthly deposits and pays your submitted expenses.
What happens to the money when I die?
Upon your passing, any remaining funds in the trust typically remain with the nonprofit. Some organizations allow for limited distribution to heirs depending on the agreement.
Can this be used for nursing home Medicaid?
No. Pooled income trusts are primarily used for Community Medicaid, not for institutional (nursing home) care.
Do I need a lawyer to create a pooled trust?
While not required by law, working with an elder law attorney ensures that the trust is properly structured, compliant with Medicaid rules, and optimized for your situation.
Contact Angiuli & Gentile, LLP Today
If you or a loved one is applying for Medicaid but facing income-related disqualification, a Medicaid pooled income trust may be the solution. Let Angiuli & Gentile, LLP help you protect your benefits and maintain your quality of life.
We proudly serve seniors and families across Staten Island, Brooklyn, Queens, Manhattan, and the Bronx.
Contact us today to schedule a consultation with our experienced attorneys.
