Financial Planning - Qualify for Medicaid


You’ve worked your whole life to save up your nest egg, only to be told you have to either spend down your income or pay for elder care out-of-pocket. The State of New York set the 2018 annual income limit at just $14,800 for a 2-person home. While this sounds like an impossibly low number, there’s actually an element missing from the explanation. $14,800 is the limit for non-countable income, and any amount you make above that is considered countable.

This means that many Americans are easily eligible for Medicaid in combination with some financial planning of their extra income. There are many options available to plan your money to allow your loved one to qualify for Medicaid and use their extra income for other important things like:

Ensuring the spouse at home can continue to pay their bills

Provide extra treatments to improve quality of life

Preserve assets to leave an inheritance for the family

Emics Medicaid Planners work one-on-one with your case to come up with the best strategy for your financial situation. Filing for Medicaid saves money to give you more freedom and peace of mind. We help you apply for Medicaid and obtain necessary paperwork. 

Read about a few of the options available below, or contact us to get started today. 

Many Options Are Available - Most New Yorker's Qualify For Medicaid

Pooled Income Trust

People of any age can use a Pooled Income Trust to become financially eligible for Medicaid home care or long-term care.  It’s unique in that it allows recipients to hold on to their assets while still qualifying for Social Security Income (SSI) and Medicaid. People of any age can become beneficiaries of Pooled Income Trusts.

The great thing about this type of trust is that the trustee can still use their money to pay for recurring non-medical bills. Utilities, home payments, new credit card charges, food receipts, and more can be set up on a monthly payment schedule. Their bills get paid, which gives any loved ones at home the peace of mind that they are still financially secure.

Deed Transfers

It’s possible to simply transfer your home deed into your spouse’s name in order to qualify for Medicaid. It can be transferred to your spouse, or any number of eligible people, without affecting eligibility or putting your home at risk. New York has a home equity limit of $858,000, so any home below that isn’t counted against your eligibility.

If one spouse needs Medicaid and nursing home care, they are considered the institutional spouse. The spouse at home is referred to as the community spouse. The community spouse can keep half of their countable assets up to 123,600, and this still allows the institutionalized spouse to qualify for Medicaid coverage. Keep in mind that Medicaid might seek some reimbursements from the countable assets after coverage is no longer necessary. Speak with us to learn more.

If you decide a deed transfer is the right option for you, an Emics Elder Care Medicaid Planner will coordinate and liaison with one of our trusted attorneys to arrange the legal details.

Irrevocable Trust

 Medicaid seekers with a large amount of assets should consider an irrevocable trust. With the guidance of an attorney, an irrevocable trust allows you to transfer any assets into a trust permanently. This legally moves the ownership of those assets from your hands to the trusts, and thereby prevents those assets from counting against you for Medicaid eligibility. The grantor cannot make changes or reverse the trust once it’s been set it place. In this instance, an Emics Medicaid Planner will coordinate and liaison with one of our trusted attorneys to arrange the legal paperwork. 

Spousal Refussal

Spouse refusal is an option of Elders who have a loved one who still lives at home. In the state of New York, if the community spouse refuses to put any income towards the costs of the institutionalized spouse, Medicaid is required to solely consider the assets and income of the institutionalized spouse.

In 2018, the community spouse is entitled to no less than $74,820 of the couples combined income for community spouse resource allowance (CSRA). This also entitles the community spouse to retain $3090.00 of their combined monthly income for the minimum monthly maintenance allowance (MMMA ). If the community spouse’s income alone is greater than that, Medicaid requests that they contribute 25% of that excess towards the institutionalized spouse’s medical costs.

The community spouse can refuse this request, in which case an Emics Medicaid Planner will put together a spousal refusal. The Medicaid agency can then choose grant the spouse in long-term care Medicaid eligibility without pursuing the resources of the community spouse.

Promissory Note


A Medicaid-compliant promissory note is another creative option available to gain Medicaid eligibility in New York. A promissory note is a legal document in which one party promises another party to pay a certain amount of money. It can be paid on-demand, or in installments by a certain date. In order for this to be set up properly, the loan must include a gift of assets or a non-exempt transfer.

Initially, setting up this gift of assets will cause you to become ineligible for Medicaid for a penalty period. However, the assets in the promissory note can then be used to pay the nursing home facility costs during that penalty period. 

An Emics Medicaid Planner will help to coordinate this which will allow you to ultimately become Medicaid eligible, while also keeping the spending of your own resources to a minimum.