Most families don’t think about Medicaid until care is needed — and by then, it’s often too late to protect what they’ve built. One of the most confusing parts of New York’s Medicaid system is the five-year lookback rule.
Many homeowners fear that this rule means they’ll have to lose or spend down everything before they can get help. But with proper planning, you can protect your home and savings, qualify for home-care benefits right away, and set yourself up for future nursing-home eligibility — all without giving up control of your property.
Here’s how it works — and why now is the time to act.
The Five-Year Lookback Rule — What It Really Means
When applying for nursing-home Medicaid (also called institutional Medicaid), New York State reviews your financial history for the five years prior to your application.
If you transferred assets — such as your home, bank accounts, or investments — during that time, Medicaid can impose penalties that delay coverage for nursing-home care.
That’s why early planning matters: the sooner your plan is in place, the sooner that five-year clock starts ticking. Once the period has passed, the assets you protected are no longer subject to recovery or penalty.
Community Medicaid: No Lookback (For Now)
Here’s the opportunity that most people don’t realize exists:
As of today, New York has not yet implemented a lookback period for community Medicaid — the program that covers home-care services, aides, and assistance while you continue living at home.
That means you can:
- Create a Medicaid Asset Protection Trust (MAPT) now,
- Transfer your home and savings into the trust, and
- Apply for community Medicaid immediately — without waiting or being penalized.
This unique window allows you to receive home-care benefits today while your five-year nursing-home protection clock runs quietly in the background.
By the time you may ever need nursing-home care, your assets can already be fully protected.
Why Acting Now Matters
New York has discussed adding a 30-month lookback period for community Medicaid, but it has not yet taken effect. When it does, transfers could trigger waiting periods just like nursing-home Medicaid.
Setting up your trust before those rules change lets you lock in the current, more favorable system.
Once your assets are in a Medicaid trust:
- You can qualify for home-care coverage right away,
- You maintain control and continue living in your home, and
- You protect your property from future nursing-home costs.
For homeowners in Long Island and New York City, this is one of the most powerful planning opportunities available right now.
The Medicaid Asset Protection Trust (MAPT)
A Medicaid Asset Protection Trust is the foundation of smart elder-law planning. It allows you to:
- Keep living in your home and keep your independence,
- Remove your property from countable assets for Medicaid purposes,
- Start the five-year clock for nursing-home coverage,
- Qualify for community Medicaid immediately, and
- Preserve important tax benefits like the capital-gains exclusion and the step-up in basis for your heirs.
Unlike simply transferring your home to your children, a properly drafted MAPT also shields your property from your child’s potential divorce, debt, or lawsuits.
Real-Life Example
Mrs. S, a 78-year-old homeowner in Nassau County, came to our office in 2020. We helped her transfer her home into a Medicaid trust and apply for community Medicaid.
She began receiving 40 hours per week of home-care assistance — fully covered by Medicaid — while continuing to live in her own house.
Now, five years later, if she ever needs nursing-home care, her home and savings are fully protected. Because she planned early, her five-year lookback period has already passed, and her property is secure.
Protecting Homeowners Across Long Island & New York City
At Kirshblum Taber PC, we’ve helped hundreds of homeowners safeguard their homes and qualify for Medicaid benefits without losing control of what they’ve earned.
We serve clients throughout Nassau, Suffolk, Queens, Brooklyn, Manhattan, and the Bronx, designing plans that balance care, independence, and protection.
Whether you’re preparing for the future or need home-care coverage now, we can help you create a plan that fits your goals.
Schedule Your Medicaid Planning Consultation
Don’t wait until it’s too late — or until the State changes the rules.
Take advantage of today’s favorable community-Medicaid environment and start protecting your home now.
Call 516-908-8842 or schedule a consultation online.
Let’s secure your care today and your legacy tomorrow.