Medicaid &Nursing Home Planning
Probate & Estate Administration
Estate Planning & Elder Law
Medicaid & Nursing Home Planning
Seneca County
Wayne County
Yates County
Ontario County & More
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In general, Medicaid helps pay for nursing home care only after your available resources (assets) have been spent. In other words, you’re expected to use your savings to cover the cost of care until you meet the financial eligibility requirements for Medicaid.
However, elder law attorneys can often implement strategies that preserve a substantial portion of a client's assets.
When you apply for Medicaid to cover nursing home care, the county will review any uncompensated gifts or transfers you made in the five years before your application.
This is known as the “5-year lookback” period. If resources were gifted during this time, you will face a penalty period of ineligibility before Medicaid benefits can begin.
Emergency Planning for Nursing Home Care
Emergency Planning for Nursing Home Care refers to legal and financial strategies used when a loved one is already in a nursing home or is about to be admitted, and Medicaid has not yet been secured. Even if no prior planning was done, it is often still possible to preserve a substantial amount of assets:
Single applicants may preserve 40% to 60% of assets using the gift and promissory note strategy.
Married couples may preserve up to 100% of assets through tools such as spousal refusal.
Acting quickly with the guidance of an experienced elder law attorney can make a meaningful difference in protecting assets and securing care. If you or a loved one is facing nursing home care, contact us today to explore your planning options.
About
The History of the Bonney Law Firm PLLC
Established in 1952 (originally as Bonney and Nicit), Bonney Law Firm PLLC is the oldest law practice in Waterloo.
Sam Bonney welcomed his son Gregory into the practice in 2016, just as Sam’s father Theodore (Ted) welcomed him to the firm in 1975. Prior to establishing a firm in Waterloo, Ted had practiced with his father, Nelson Bonney, in Norwich, NY.
Sam retired in June, 2021. Many of our clients and their families have been with our firm for decades.
Medicaid Planning & Asset Protection FAQs
What is Medicaid Crisis Planning?
Medicaid Crisis Planning is emergency legal planning used when someone needs nursing home care immediately or within the near future. It helps families protect assets while establishing eligibility for Medicaid, instead of losing everything to private-pay nursing home costs.
Do we have to spend all of our savings before Medicaid will help?
No. Most families can protect a significant portion of assets, including savings, retirement accounts, and even the home, with the right planning strategies. You do not need to spend everything down. Acting quickly is key.
What is the Medicaid 5-Year Lookback?
Medicaid reviews all gifts or transfers made within the past five years. Any transfers that weren’t for fair market value can create a penalty period during which Medicaid will not pay for care. There are exceptions for transfers to a spouse or to a disabled child.
Can the home be protected?
Yes. The home can often be kept if:
• A spouse still lives there
• It’s transferred to a disabled child, caretaker child, or a sibling with equity interest
• The applicant files “intent to return home” (during a single-applicant case)
Strategies differ for single and married individuals.
Can retirement accounts be protected?
Yes. Retirement accounts (IRA, 401k, 403b) are treated as income streams, not assets. Medicaid requires them to be put into monthly payout status for the applicant, but the Community Spouse’s accounts are not affected.
Is it too late to plan if a loved one is already in a nursing home?
No—this is exactly when crisis planning is used. Even after admission, families can still protect assets through strategies like:
• Spousal Refusal
• Gift and Note
• Purchasing exempt resources
• Caretaker child home transfers
• Disabled child transfers
