Cuomo Imposes New Restrictions on Home Care and Assisted Living Medicaid – UPDATE 12-21-20

December 21, 2020 Austin F DuBois

In light of New York's budget woes, Governor Cuomo empaneled a Medicaid Redesign Team to further restrict people's access to Medicaid. On October 1, 2020, a particularly big change is coming for Home Care and Assisted Living Medicaid.

***UPDATE – December 21, 2020***

The NYS Department of Health recently announced the new Home Care Medicaid Look-Back will not be implemented until April 1, 2021. The NYS Department of Health also verbally confirmed if the application is filed prior to that date, they will not look at prior transfers (as opposed to applications that have been filed, but not yet reviewed and considered by a case worker until after that date).

What does this all mean? Essentially, if you or a loved one has a need for in-home or assisted living (to confirm, not nursing homes) long term care now, or will within the next few months, you need to begin planning and complete the application process ASAP. By doing so, you will help ensure you are protecting your or a loved one’s assets from having to otherwise be spent down on care.



***UPDATE – June 28, 2020***

It has recently been confirmed by the NYS Department of Health that the new lookback period will only apply to transfers made on or after October 1, 2020. This is hugely important if you or a loved one may need some help in the home or in assisted living over the next two or three years. Doing the right planning before October could mean the difference between spending tens or hundreds of thousands and Medicaid simply covering it immediately.

We are here if you’d like to talk about your options.



Cuomo’s Medicaid Redesign Team came up with several proposals that were put into the NYS budget, one of which will heavily restrict middle class people’s access to Home Care and Assisted Living Medicaid.

It is often surprising to our clients, but it is relatively “easy” to qualify for Medicaid if you want it to cover your care in the home, or in certain Assisted Living facilities. While those situations do require proper advice from an experienced Elder Law attorney, people are allowed to transfer assets out of their name to anyone (though it is usually close family), and become eligible for Medicaid almost immediately. So for my clients that are applying for Home Care and Assisted Living Medicaid now, it usually only takes a few weeks, at worst a couple months, for them to begin receiving Medicaid coverage, which in many cases saves them hundreds of thousands of dollars.

This is different from Nursing Home Medicaid, which has a “five year look back” for transfers to people other than spouses and disabled children (and a few very esoteric others). For Nursing Home Medicaid, if you make any non-exempt transfer within the five years prior to applying, you will be hit with a “penalty period”, which delays your Medicaid coverage for anywhere from a few months to a few years. So you have to figure out how to try and pay for the nursing home yourself (average nursing home cost in the Hudson Valley pushes $13,000 per month). To be sure, we have a way of handling that, but we would always rather not have to worry about a “look back” period.

As of October 1, 2020, a new “look back” period will apply to Home Care and Assisted Living Medicaid cases. This “look back” will be thirty (30) months, or two and a half (2.5) years. At the moment, there is some uncertainty in how and when it will apply, but there is legislation pending, as well as a history of how state and county agencies have handled these situations, to assure us that we will be able to the use the same technique we use to protect people’s homes and savings when applying for Nursing Home Medicaid. There are some modifications that as attorneys we will have to make, but we are glad that we have been doing look-back period planning for many years so we’re able to handle this new development.

However, it is still concerning. We always enjoy being able to tell our hardworking clients and their families, that despite their humanity and need for some degree of long-term care, that we can outright protect their homes and savings, with no need to spend much on their care. That appears to be going away.

If you or a family member believe that some home care or assisted living Medicaid is going to be needed sooner than later, now is the time to plan. And for everyone who is concerned that perhaps you’ll need long-term care in the future, and don’t want your home and savings spent on that care, there are plenty of techniques we can use proactively, well in advance of five years, to ensure that the largest possible amount of your hard-earned savings are preserved for you and your family.

If any of this is a concern to you, please give us a call, or “Like” our Facebook page for regular updates.