The prospect of a spouse needing nursing home care is one of the biggest financial worries for couples. With some facilities on Long Island now charging more than $600 a day, even with long-term care insurance policy benefits, the monthly out-of-pocket cost of a room in a nursing home can easily exceed $6,000.

For couples who worked hard throughout their careers and saved to own a home and healthy retirement accounts, the thought of impoverishing a well spouse so the sick spouse can apply for Medicaid is frightening.

When family members determine they know what to do, the results are often disastrous. The Medicaid Program, funded by the federal and state governments, is extremely complex, and you are dealing with both federal and state law. Many Medicaid strategies can have unintended federal and state tax consequences. They transfer homes and other assets to family members and change the names on various bank and investment accounts. But, if a person needs Medicaid within five years of a transfer, they are ineligible for Medicaid.

There are ways to protect assets. A personalized asset protection plan prepared by an experienced Elder Law attorney will assure the plan stands up to Medicaid scrutiny.

What does work is pre-planning with an experienced Elder Law attorney

Our firm works with families and individuals facing the challenges of ensuring their loved ones receive the care they need while protecting their accumulated assets over a lifetime. The earlier this planning takes place, the more options the person will have.

Medicaid Asset Protection Trust is used to allow a person to qualify while protecting assets. The family home, investment accounts, etc., can be placed in the trust and are not countable. If investments fund a trust, the prior owner may not sell them but can continue to receive income if the MAPT restricts payments only to income.

A MAPT trust must be created and funded five years before the application. Some assets cannot be transferred into the trust. They may need to be liquidated and placed in the trust.

There are numerous other strategies, depending on the individual’s situation.

Medicaid Compliant Annuity is another way to reduce non-exempt assets so a person can qualify for Medicaid. The Medicaid compliant annuity is a single premium immediate annuity (SPIA). Upon payment of the premium, the healthy spouse receives equal monthly payments for the payment period selected. Medicaid must be named the initial beneficiary to Medicaid paid for care. Any amount remaining goes to the family.

Annuities are complicated financial products. There are many ways to structure an SPIA. An experienced Elder Law attorney has the knowledge and experience to ensure the SPIA meets the family’s needs.

There may be other strategies when a person requires institutional care. It is known as Medicaid Crisis Planning. Medicaid Crisis Planning strategies differ significantly from the Medicaid pre-planning. However, they are not mutually exclusive and can increase the ability to protect assets.

Our practice helps people with Medicaid planning and Medicaid crisis planning. If you have questions, we invite you to call 516-307-1236. Please note that we limit our practice to New York State and Florida.

This article was provided by Stephen J. Silverberg, Attorney at Law, Founder of the Law Office of Stephen J. Silverberg, P.C., one of New York’s TOP Elder Law and Estate Planning Law Firms.  Attorney Silverberg and his firm are Members of the ElderCare Matters Alliance and have a Featured Listing on– America’s National Directory of Elder Care / Senior Care Resources to help families plan for and deal with the issues of Aging.

If you have additional questions about your family’s Elder Care / Senior Care Matters, you can count on (America’s National Directory of Elder Care / Senior Care Resources) to help you find America’s Top Elder Care / Senior Care Professionals.  You can find Local Elder Care / Senior Care Experts by Searching our National Database by City and Service Category.  (This Search feature is located on the homepage of

The Elder Care / Senior Care Experts that are found on can provide you with the help you need in a total of 78 different Elder Care / Senior Care Services, including Elder Law, Estate Planning, Home Care, Medicaid Planning, Assisted Living, Care Management, Daily Money Management, Senior Living, Investment Advisory Services, Tax & Accounting Services, Wills & Trusts, Probate plus many other Elder Care Services.

We look forward to helping you plan for and deal with your family’s Issues of Aging.


MEDICAID INFORMATION THAT CAN PROTECT YOUR FAMILY’S ASSETS was last modified: April 7th, 2023 by Stephen J. Silverberg, Esq.