Unfortunately, your risks are still high. According to the U.S. Department of Health and Human Services, “About 70 percent of people over age 65 need some type of long-term care during their lifetime. More than 40 percent need care in a nursing home for some period of time.”

If you do need care, the costs are so high that it would not be overly dramatic to say that your life’s savings could be wiped out very quickly, well before you pass on. You could be left in poverty at the very moment in time when you are most vulnerable.

The cost of care is probably the most serious risk that seniors face.  You can learn how to avoid potential disaster by informing yourself about Elder Law planning, and by taking action.

You are not alone. Most seniors cannot afford long-term care insurance, and might not qualify anyway. Those who purchased a policy often find that the benefits are insufficient.  Information about the issues and problems with long-term care insurance can be found here.

The best alternative is to consult with an Elder Law attorney about creating a plan to become eligible for Medicaid benefits, and to protect your assets and income at the same time.  Start learning about Elder Law planning now!

There are no hard and fast guidelines – it depends on the state of your health as well as your age. The most important thing is to inform yourself about the risks you face and the options and solutions available to you.

When you are in your 60’s, it is certainly a good time to become informed.  You should already have a Power of Attorney with an appropriate scope of authority granted to your Agent, and a Health Care Proxy.

Probably by the time you are in your 70’s, you should be taking steps to protect your assets against the ruinous costs of long-term care.  Health problems can appear quickly - the more prepared you are beforehand, the better.

If it turns out that you are among those few (about 3 out of 10) who never need long-term care, or if you have sufficient long-term care insurance, you are probably okay. Unfortunately, you are more likely to end up among the 70% of people over 65 who will need long-term care.  Unless you have a significant amount of long-term care insurance, you could easily end up in serious financial jeopardy.  Long-term care is – literally – ruinously expensive.

You would be well-advised to explore your options by consulting with an Elder Law and Estate Planning attorney.  Your attorney can help you implement a plan to protect yourself and your family against financial disaster.  Perhaps amending your living trust to make it an irrevocable trust would be a good solution, provided that it is properly funded. Your attorney may have other solutions as well.  Visit our page on Estate Planning to review topics you need to consider.

Medicare is a federal government program that provides medical insurance for payment of expenses for medical care and rehabilitation from illnesses and injuries. Medicare does not cover long-term care.

Medicaid is a federal and state partnership program that provides a broad range of medical and health benefits, including long-term care. The two programs are very different as to coverage, rules, and eligibility.

Medicare is essentially the same nationwide, but Medicaid differs, often significantly, from state to state.  Learn more here.

Most people become eligible for Medicare at age 65.  Certain disabilities or medical conditions may allow earlier enrollment.

Medicare is medical insurance.  It does not cover long-term care. The only program that covers home care, assisted living, or nursing home care, is Medicaid.

Medicaid is also medical insurance, but the network of providers is much smaller than for Medicare.

These are common misconceptions about Medicaid. Almost everyone can qualify for Medicaid in New York with appropriate Elder Law planning.  Don’t give up prematurely – find out what your options are.  And don’t delay - the earlier you get informed, the earlier you can take action.

Our website has information on how you can become eligible for Medicaid services, depending on your needs.  If you need care in your home, or Assisted Living, you can find information here: Community Medicaid.

If you need Nursing Home care, you can find information on our page about how to become eligible for Nursing Home Medicaid.

There is no requirement that you retain an attorney to prepare your Medicaid application. However, most people find that completing the application is a daunting and confusing task. When you prepare your own application, you risk doing it incorrectly.  Errors could compromise or delay your eligibility for benefits for months.  Such delays can cost you thousands of dollars – far more than the cost of hiring an attorney.  Read more here

When an experienced Elder Law firm handles your application, you can be confident that it will be approved, and you’ll save yourself a lot of time and aggravation in the process. Also, before filing your Medicaid application, your attorney will have protected your assets and income to the extent legally permissible, and have put you and your family in the best possible position going forward.

You may have seen advertisements or solicitations from independent "Medicaid Experts," or paralegals, social workers, or geriatric care managers. These companies claim they can handle your Medicaid application for a lower fee than a law firm would charge. However, none of them are qualified to give you legal advice about the steps you can properly take to obtain Medicaid eligibility.  Nor can they give you legal advice about how you can protect your assets or income.

We have seen cases where these “Medicaid Experts” have provided incorrect legal advice, to the detriment of their customers.  This is discussed in more detail in “Only Hire an Elder Law Attorney for Medicaid and Long-Term Care Issues.”  This is Strategy #6 of our publication “25 Strategies to Prevent Financial Ruin from Long-Term Health Care Costs.”

Yes, you can. In most cases, it makes sense to keep your Medicare, even if you have been approved for Medicaid. You will be able to continue seeing the same doctors and have access to a larger network of doctors and other medical providers.

- Medicare is medical insurance. It covers medical care and rehabilitation.

- Medicaid is the only government benefit program that covers long-term care. Medicaid is also medical insurance, but the network of providers is much smaller than for Medicare.

Learn more about keeping your Medicare if you are on Medicaid here.

Short answer:  No, you do not.  Spending down virtually all of your money is a disastrous and usually unnecessary path to becoming eligible for Medicaid. There are entirely legal and proper strategies to help you avoid that outcome.  The strategies can be used to protect your assets and your income, and at the same time enable you to become eligible for Medicaid. Click here for a discussion on achieving Medicaid eligibility.

For effective planning, if you are making any transfers of your assets now, you  may want to consider the five-year look back period that applies to Nursing Home Medicaid.

“Too much money” is ambiguous and misleading.  Almost everyone can become eligible for Medicaid.  The key is to realize that “money” needs to be separated into two categories – assets and income.  Medicaid treats the two categories differently. If you are over 65, your income will not affect your eligibility.  The test for eligibility focuses only on your assets.

Medicaid does not ignore income, but it is dealt with in different ways, depending on which type of Medicaid you receive.  Your income will not stand in the way of your gaining access to Medicaid benefits.  Read about how income is handled here.

For Community Medicaid (Home Care or Assisted Living), you are free to transfer your assets to a trust, or to a family member or friend, and then apply for Medicaid benefits without delay.

For Medicaid Nursing Home benefits, you are also subject to the five-year “look back.” Transferring assets at any time during the five years before you submit a Nursing Home Medicaid application may subject you to a period of ineligibility (the “penalty period”) for Nursing Home Medicaid benefits.  The penalty period is  calculated by Medicaid based upon  the amount of assets you transferred.

Find out more in our post, “What is the Medicaid “Look Back,” what is the “Penalty Period,” and how do they work?”

No.  Nobody will get in trouble. There is nothing illegal or improper about transferring your assets to family members or to a trust. However,  transfers may affect the timing of your eligibility.  If you are applying for Medicaid Nursing Home care, and have made transfers within the “look back” period, you may be subject to a “penalty period” during which Medicaid will not pay your nursing home bill.

Note that certain transfers are exempt and do not trigger a penalty (for example, transfers to a blind or disabled child).  However, the “look back” does not apply to Medicaid’s Home Care or Assisted Living programs.

Further, if you are applying for Medicaid Nursing Home benefits and you are subject to a “penalty period,” there are often Elder Law strategies available to reduce the penalty and save a substantial portion of your assets.  Read more about this issue here.

The “look back” period is the five-year period extending back from the date of your application for Medicaid Nursing Home benefits. Medicaid requires documentary proof of all of your financial transactions during this period, to determine whether you made any gifts or transfers of your assets. Transfers and gifts that you made within the “look back” period are subject to a penalty that may delay your eligibility for Medicaid benefits.

Note that the look back does not apply to Community Medicaid benefits.

For effective planning, if you are making any transfers of your assets now, and hope to have Medicaid pay for your nursing home, you need to take the five-year look back period into account.  Click for more information on the Medicaid Look Back.

The “look back” will not prevent you from applying for Medicaid, but it may result in a delay of your eligibility for Nursing Home benefits. It is a primary reason why it is important to become informed of your rights and options, and to plan ahead.  Click here for more information on the “look back.”

If you are in a nursing home, and ask Medicaid to pay the nursing home’s bills, there is a hurdle.  Medicaid will not pay your bill for a period of time if you have made any gifts or transfers of your assets during the five years preceding your Medicaid application.  This five-year period is called the “look back.”  The number of months that you are not eligible for Medicaid benefits is called the “penalty period.”

The penalty period is calculated by Medicaid based on the transfers made during the look back period.    The amount or value transferred is divided by Medicaid’s “regional rate” for nursing home care in the county where you live. The result of this calculation is the number of months of ineligibility (the “penalty period”).

The regional rates change each year.  The current levels can be found in our Medicaid Quick Reference Chart.

During the penalty period, you are in the nursing home and have little money, but Medicaid will not pay for your care.  Someone else is required to pay.  Often it ends up being the person to whom you originally transferred your money.  Without planning, the result can be that all the money you gave away, and often more, ends up being used to pay the nursing home. .

More information on the look back and penalty period can be found here.

You may be able to protect some of your assets even if you are in this situation.  Don’t let the “look back” and the “penalty period” deter you from seeking the advice of an Elder Law attorney. He or she will likely have a strategy that can save you a significant amount of money, even if you made a gift or transfer that subjects you to a penalty period. Find out more in our post, “Private Annuities Can Help Protect Your Assets.”

No, it is not too late, even if you are already in a nursing home.

Most Elder Law strategies can be implemented quickly. If you need Home Care or Assisted Living, you can create an excellent plan that can protect your money, and it can take effect with little delay.

If you need Nursing Home care, your ability to protect your assets may be more limited than if you had planned ahead. However, even in a worst case scenario, it is likely that you could still protect 40-50% of your assets.

Read more:  “Achieving Medicaid Eligibility”

Consulting with an Elder Care attorney, even when you think it might be too late, can often show you that you still have options.  Lamson & Cutner attorneys often meet with clients who are in crisis situations.  The clients are relieved to learn that they can still act and achieve excellent results.

Yes, of course.  All of Lamson & Cutner’s recommendations and strategies are based on provisions of Federal or New York State laws or rules, and are entirely proper. They’re time-tested, reliable, and cost effective.  You have helped pay for government programs through your taxes and payroll deductions.  If you are eligible, there is no reason you shouldn’t benefit from the programs you helped to fund.

We do not believe in taking risks or employing so-called “cutting edge” strategies for our clients. We want clients to be secure in the knowledge that they are acting properly and responsibly in seeking benefits that they are entitled to receive.

If you’ve saved money and paid your taxes, you don’t want to put yourself in a position where you would have to live out your remaining years in poverty, or leave your spouse or children in a difficult financial position, when Medicaid benefits are available to you.

It’s generally good to have a Will, but a Will only deals with distributing your assets and addressing other wishes once you have died. It is totally ineffective as an Elder Law planning tool. It won’t protect your assets against the catastrophic costs of long-term care while you are alive. It will also leave your Executor and heirs with the chore and the expense of going to court.  If your estate is controlled by a Will, it must go through probate, the court proceeding to determine the validity of the Will and the rights of heirs at law who may want discovery or make objections.

Probate takes  time and can be expensive.  It is often frustrating because there are frequently delays that your attorney cannot control or avoid.

For estate planning purposes, you might want to consider a Trust.  A Trust is a private document that avoids probate and allows for the quick and efficient distribution of your estate to your beneficiaries.  At the same time, the Trust can be designed to protect your assets, and to facilitate Medicaid eligibility.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

Estate taxes are a concern for only the wealthiest citizens. Only about one-tenth of 1% (0.1%) of estates pay Federal Estate Tax. State estate or inheritance taxes might have lower thresholds, but again, it will not be a concern for most people. In NY, the exemption has been over $5 million per person since 2018, and has increased significantly since then. The current levels can be found on our 2026 Estate Taxation Quick Reference Guide.  Major changes could occur, but none are anticipated at this time.

The Gift Tax form that people are concerned about does not mean that you will pay taxes on gifts that are larger than the annual federal exclusion amount.  It is only a way for the Internal Revenue Service to keep track of your lifetime gifts, which are included in your taxable estate.  Of course, if you exceed the Gift and Estate Tax exemption during lifetime, your gift will be subject to tax.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your Estate Plan at the same time. Usually, the same strategies and legal documents serve both purposes.  Read about Integrating your Estate Plan with your Long-Term Care Plan.

Avoiding probate is a worthwhile goal and is generally easily achievable. Probate is a court proceeding. It can be frustrating, expensive and subject to delays of all kinds.

Also, probate sometimes results in a prolonged dispute among disgruntled family members or others, which increases expenses and delays distributions to beneficiaries.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your Estate Plan. Usually, the same strategies and legal documents serve both purposes.

Yes, by all means. Trusts are the main “workhorses” of Elder Law planning. They are the most prudent way to protect assets, create an effective Estate Plan, and facilitate Medicaid eligibility.

A Trust is an agreement between a Grantor and the Trustee(s) who will manage the Trust.  Trusts are not only for “the rich.”  We will explain if a Trust is appropriate in your situation from a cost-effective and a practical point of view.  If it is, we will explain the reasons Trusts are useful in variety of ways.

There are numerous types of Trusts.  The types most frequently used by Elder Law and Estate Planning attorneys are Revocable and Irrevocable Trusts.

Click for more information on Trusts in Elder Law and Estate Planning

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your Estate plan.  Usually, the same strategies and legal documents serve both purposes.

The basic difference is that Elder Law planning seeks to ensure that you will have the health care (particularly long-term care) that you may need, and protect your income and assets at the same time.

Estate planning is concerned with implementing your wishes and distributing your assets after you pass on, in the most efficient and tax-advantaged way. Elder Law planning and Estate Planning can – and should – go hand in hand.  Read more – Why and How to Integrate Estate Planning with Long-Term Care Planning

Estate planning attorneys who are not experienced in Elder Law may ignore the financial risk of long-term care costs. Without a good Elder Law plan to preserve and protect your assets and income while you are alive, you may find that, while you have lovely estate planning documents, you have no estate.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

We believe that there are several qualities about Lamson & Cutner that make us stand out. First, our sole practice areas are Elder Law and Estate Planning. Our focus is on the concerns of seniors and the disabled, and on people who want to create a plan for their estate.  Lamson & Cutner offers a great depth of knowledge and experience in our practice areas. Few law firms could match our track record of successful Medicaid applications.

Second, Elder Law is about helping people and families. Each of our attorneys and staff members has a real passion about what we are doing. We’re happy and proud to achieve great results for our clients.

Third, we want our fees to be cost-effective for clients, and we think that is good business. In most cases, we will offer a fixed fee, and we’ll assume the risk of your matter becoming more complicated than anticipated.

Fourth, we provide a high level of personal service. We are always available to our clients, and welcome the opportunity to address your questions and concerns as our work progresses on your behalf.

A “free consultation” is typically a short one that does not fully address your situation and your concerns.  We do not believe it is an effective use of our time or yours.

During an initial consultation with Lamson & Cutner, one of our attorneys will typically spend two hours or more with you to fully understand your situation, explain applicable laws and rules, discuss your options, make a plan, and discuss our fees.  You will be sitting down with an attorney who is knowledgeable about Elder Law and Estate Planning.  The attorney will give your situation the time and attention it needs.

We take as much time as required, and will answer all your questions.   Clients often tell us that we explain everything very clearly.  They gain peace of mind and confidence that they will be taking the steps that are right for them.  They frequently volunteer that their consultation was extremely valuable.

A longer discussion can be found here.

You’ll sit down with an Elder Law attorney who will make a detailed assessment of your situation, your financial status, your needs for health care and long-term care now and in the future, the needs of your spouse or others close to you, and your estate plan. The consultation will focus on how to get the care you need or might need in the future, and how to pay for it.

If Medicaid benefits are desired and are appropriate, the process of gaining approval of an application for home care or nursing facility care will be thoroughly explained to you. The firm will map out an effective strategy to protect as much of your money, income and assets as legally possible, and to create your estate plan at the same time.

To make your consultation as effective and complete as possible, Lamson & Cutner will want detailed information about your situation.  The firm will send you an Initial Consultation Checklist of documents and information to bring with you.

Each situation is unique, and fees can only be quoted once a full assessment is made at your Initial Consultation. Lamson & Cutner wants its services to produce an excellent, cost-effective, result. We won’t take your case, or suggest a strategy, unless we have a very high degree of confidence that we will succeed in meeting your goals.

In most cases, we will propose a fixed fee, so you will know in advance exactly how much our legal services will cost. Because of our deep knowledge and experience in Elder Law, we accept the full risk that your case might turn out to be more complicated than anticipated. There are never any extra fees or hidden costs, and you can feel free to contact the firm at any time with your questions or concerns while your matter is pending.

Unlike what happens with some firms, our services do not end with creating and having you execute your documents.  We also help you implement the plan we have developed with you.  This is a key component of our services.  Certain of your documents, such as a Trust, will be useless, unless you implement your plan and fund your Trust.

We take pride in knowing that the plan we have helped our clients create and implement is fully in place, and working as intended.