Protect What You've Saved: Veterans & Medicaid Trust Planning in New York

New York's Medicaid Lookback Rule Makes Early Planning Essential

New York applies a 5-year lookback period to Medicaid applications for nursing home and long-term care coverage. That means any assets transferred out of your name within five years of applying can be counted against you, potentially delaying your eligibility for months or years. An irrevocable Medicaid trust, established well before you need care, moves assets outside that lookback window legally and permanently.

This is not a loophole — it is a recognized and documented planning strategy used by elder law attorneys across New York. The key is acting before a health crisis forces the decision. Families who wait until a diagnosis or hospitalization often find the five-year window has closed on their options. Families who plan ahead keep their savings intact.

What an Irrevocable Medicaid Trust Actually Does

An irrevocable Medicaid trust is a legal arrangement in which you transfer ownership of your assets — typically your home, savings, or investments — into a trust you no longer personally own. Because the assets are no longer in your name, they are not counted as resources when Medicaid evaluates your eligibility.

You retain the right to live in your home and receive income from the trust during your lifetime. What you give up is direct control over the principal. That trade-off is significant, and we walk every client through it carefully before any documents are signed. For many families in Nassau County and across Long Island, it is the most effective legal tool available for preserving generational wealth while still qualifying for Medicaid when care is needed.

Veterans Aid & Attendance: A Benefit Too Many Families Miss

If you or a spouse served in the military, you may qualify for the VA's Aid & Attendance benefit — a monthly payment designed to help cover the cost of home care, assisted living, or nursing home expenses. This benefit is separate from Medicaid and is available to veterans who meet service, medical, and financial criteria.

Trust planning can help veterans structure their assets in a way that supports Aid & Attendance eligibility without inadvertently disqualifying them from Medicaid down the road. The two programs have different rules, different lookback periods, and different asset thresholds — and coordinating them requires careful legal planning. Many families are unaware the Aid & Attendance benefit exists at all. If a veteran in your family needs care, this is worth a conversation.

Irrevocable Medicaid Asset Protection Trust

This is the primary tool for protecting a home or other significant assets from the Medicaid spend-down requirement. Once the trust is established and funded, the assets it holds are no longer counted as yours for Medicaid purposes — provided the five-year lookback period has passed. We draft these trusts with your specific family situation in mind, including how the home will be managed, who serves as trustee, and what happens to the assets after your passing.

Veterans Trust Planning

For veterans pursuing Aid & Attendance benefits, we structure trusts that align with VA financial eligibility requirements while preserving long-term Medicaid planning options. Because the VA and Medicaid apply different rules to asset transfers, getting this coordination right from the start prevents costly mistakes later. We review your service history, current asset picture, and care needs before recommending a structure.

Supplemental Needs and Special Needs Trusts

When a family member with a disability may eventually rely on government benefits, a special needs trust ensures that an inheritance or settlement does not disqualify them from Medicaid or SSI. We draft these trusts to hold assets for the benefit of a disabled beneficiary without counting those assets against their eligibility. This planning is often combined with broader Medicaid and estate planning for the same family.

Revocable Living Trusts as Part of a Broader Plan

A revocable living trust does not provide Medicaid protection on its own — assets held in a revocable trust are still counted as yours. But it plays an important role in a comprehensive estate plan by avoiding probate, maintaining privacy, and allowing for a smooth transfer of assets to your heirs. We often use revocable and irrevocable trusts together to address both lifetime care planning and what happens after.