Estate Planning Isn’t Just For The Elderly

Happy, smiling couple in their sixties.


By Stella King, Esq.

Although there are exceptions, the vast majority of seniors desire to remain in their homes and maintain as much independence as possible. Yet, the process of aging is inevitable, and as time marches on, the likelihood that we will need assistance with our activities daily living or “ADLs” (e.g., bathing, dressing, toileting, meal preparation) increases. Unfortunately, so does the cost of such assistance. In our experience, the cost of a private home health aide in Westchester County ranges from $30 to $35 per hour. This rate, over the course of an eight-hour day, seven days per week, translates to a monthly expense of approximately $6,720-$7,840, and roughly $80,640-$94,080 annually. New York State’s Home Care Medicaid (HCMA) program can be used to alleviate a substantial portion, if not all, of this expense, but the question always: Do I qualify?

If you are a resident of New York State, are over the age of 65 years, and require assistance with one or more ADLs, you may be a candidate for HCMA—meaning, that Medicaid would pay for the cost of a home health aide to come to your home and assist you with your ADLs. While it is true that there are both income and resource eligibility requirements for Medicaid, there are estate planning techniques that can be used to meet these requirements. For example, if your monthly income is above Medicaid’s threshold, the excess amount can be deposited into a “pooled income trust,” which allows you to become (or remain) eligible for Medicaid, but at the same time continue to use those funds to pay for your monthly expenses.

Similarly, if your assets are over the Medicaid resource limit and you are married, but only one of you needs help at home, the excess assets of the “ill spouse” can be transferred to the “well spouse,” allowing the “ill spouse” to become financially eligible for Medicaid, provided that the proper forms (e.g., spousal refusal) are submitted along with the Medicaid application. If you are either single (or married but both spouses are “ill”) the assets of the single individual (or of both ill spouses) in excess of the Medicaid resource limit can be transferred to one’s loved ones or to an Irrevocable Medicaid Asset Protection Trust in order to financially qualify for Medicaid.

Currently, there is no lookback period for HCMA. Assets can be transferred and HCMA applied for without any penalty (period of disqualification). Yet, this is subject to change. It now appears that a 2.5-year lookback period for HCMA may be implemented in 2025, making now the golden time to transfer your assets, apply for HCMA, protect your life savings from the cost of long-term care, and age comfortably in your own home.

Enea, Scanlan & Sirignano, LLP