Medicaid planning for custodial care in New York

Many aging residents of New York believe that, after the age of 65, they will be able to rely on Medicare for their health care and assisted living needs. One issue that most people are unaware of, though, is that of something called "custodial care." Custodial care is different from skilled nursing home care and, much to the chagrin of many, is not covered by Medicare. In fact, without proper Medicaid planning, this small distinction in type of care could end up costing elderly New Yorkers and their beneficiaries everything.

So what, exactly, is the difference? Custodial care is distinguished from skilled nursing home care as being routine daily living assistance for basic activities, as opposed to specialized medical care. If, for example, an elderly individual needs help with tasks such as cooking, eating or bathing, but these tasks could be performed by an unskilled home health aide, this is considered custodial care, and Medicare will pay nothing.

So what's an aging New Yorker to do? For many, the best option is to apply for Medicaid coverage, because Medicaid does help cover custodial care. However, Medicaid is a means-based program, meaning individuals with over $2,000 in assets will not receive assistance until they have spent down their savings. This spending down can mean a lifetime of careful planning and saving is quickly depleted, leaving nothing for heirs and beneficiaries.

For this reason, many individuals choose to consult a New York Medicaid planning attorney. Structuring a Medicaid plan can be complex and highly complicated, as improper planning can jeopardize coverage, meaning penalization or even disqualification. For example, the transfer of assets within five years prior to applying for Medicaid coverage can result in ineligibility. The sooner an individual consults an experienced Medicaid planning attorney, the better, as an experienced lawyer can work with aging New York individuals and their families to help ensure they'll be able to afford the long-term nursing home and health care services they'll need without exhausting a lifetime of careful saving.

Source:, "The 2 Words That Could Cost Medicare Beneficiaries Everything", Christy Bieber, Nov. 16, 2017

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