For elderly residents of New York and their families, Medicaid is not a matter to be tackled lightly. Nursing homes are expensive and most people do not have the funds to pay for long term care without a significant draining of assets. Medicaid is supposed to help pick up the cost of long-term senior health care, but the program is income-based and individuals who have not exhausted all other means may not qualify until they do so. However, it can be disheartening and upsetting for people to watch their life savings quickly disappear. This is where Medicaid planning can help.

Individuals often believe that it is simply a matter of filling out paperwork to file for Medicaid benefits, but doing so is not as easy as people may think. There are a number of common oversights and mistakes that individuals may make on their own that ultimately disqualify them from receiving Medicaid. For example, there is a “look back period” of five years that examines whether any substantial gifts of money or property were made during that time; if so, there may be penalties or disqualifications. Additional complications arise when private caregivers have been employed or when individuals have large retirement plans.

If Medicaid benefits are denied, there are several possible ways to proceed. It may be possible to speak with a caseworker to explain why the application should have been approved. In other cases, many find it necessary to file for a hearing through the Office of Administrative Hearings. Getting ready for the hearing often involves preparing a brief, which outlines relevant facts and legal precedents. This can be a complicated and time-consuming process and is often best undertaken with the aid of an attorney experienced in elder law.

It may be possible to avoid these issues altogether with careful preparation well ahead of time. Here, the knowledgeable guidance of an attorney with experience in Medicaid planning in New York may prove invaluable. A lawyer’s familiarity with the complex legal stipulations involved in the Medicaid program may save time, stress and money.

Source:, “SENIOR SIGNALS: What to do if your Medicaid application is denied”, Daniel O. Tully, Feb. 26, 2017