If you or a loved one is approaching retirement age or facing rising care needs in New York, understanding Medicaid's asset rules can mean the difference between protecting your family's savings and watching them drain away. The rules are not intuitive, and they change every year. This guide breaks down the current New York Medicaid asset limit, income thresholds, exempt property rules, and planning strategies for 2026-with a focus on what matters most to families in Orange County and the surrounding Hudson Valley.

Key Takeaways

• In 2026, single applicants must have income under $1,836 per month and no more than $33,038 in countable assets to qualify for non-MAGI (aged, blind, or disabled) Medicaid in New York. Married couples face different thresholds, with a community spouse resource allowance of up to $162,660.

• Many adults under 65 can qualify for Medicaid health insurance coverage with no asset test at all. But once you turn 65 or need long term care, strict asset limits apply.

• Certain assets are exempt from the Medicaid limit: a primary home (under certain conditions), one vehicle, personal belongings, and household goods are generally not counted. Cash, stocks, bank accounts, vacation homes, and most investment accounts are counted.

• Legal strategies such as trusts, spend-down planning, and spousal protections can help families reduce assets and protect resources while still becoming eligible for Medicaid—especially for nursing home or in home care in Orange County, New York.

• If you have questions about your eligibility or want a personalized Medicaid planning review, call Pedrani Law LLC at (201) 466-2641 or contact the firm online.

How New York Medicaid Works: Health Insurance vs. Long-Term Care

Two Types of Medicaid Coverage

"Medicaid" in New York is not one program—it covers two very different things. The first is regular health insurance coverage: doctor visits, hospital stays, prescriptions, and medical supplies. The second is long term care: nursing home stays, assisted living, personal care services, meal preparation assistance, and in home care for people who can no longer manage daily life on their own.

MAGI Medicaid for Adults Under 65

For most adults under 65, New York uses MAGI (modified adjusted gross income) rules. MAGI Medicaid does not impose an asset limit; eligibility is based only on income, tied to 138% of the federal poverty level. If you're under 65 and meet the income limit, you don't need to worry about how much is in your savings account.

Non-MAGI Medicaid for Seniors and Disabled

But for people 65 and older, or those who are blind, disabled, or seeking long term services and supports, New York applies non-MAGI rules—which include both income limits and resource limits on countable assets. This distinction matters because Medicare generally does not pay for extended nursing home care, making Medicaid planning crucial for families in Orange County and across the Hudson Valley.

Focus of This Guide

This article focuses on the New York Medicaid asset limit rules that apply when someone is 65 or older, disabled, or seeking long term care services at home or in a facility. If you're unsure which Medicaid category applies to your situation, call (201) 466-2641 or reach out to Pedrani Law LLC online for guidance.

Current New York Medicaid Income Limits in 2026

MAGI Medicaid Income Limits

New York updates Medicaid income limits each year based on changes to the federal poverty level. Here are the key 2026 figures for adults under 65 (MAGI Medicaid):

• One person: approximately $1,856 per month (138% of FPL)

• Two people: approximately $2,509 per month

• No asset test applies for standard health insurance coverage

Non-MAGI Medicaid Income and Asset Limits

For adults 65+, blind, or disabled (Non-MAGI Medicaid):

• One person: $1,836 per month

• Married couple: $2,489 per month

• Asset limits also apply (see next section)

Medically Needy Pathway and Pooled Income Trusts

The medically needy income level, which is also the monthly income limit for that category, is $1,836 per month for singles in 2026. If your monthly income exceeds the Medicaid income limits, New York may still offer pathways. The Medically Needy Pathway allows people with excess income, including those with high medical bills, to become Medicaid eligible by "spending down" their surplus with those expenses on medical costs. Pooled income trusts can help disabled individuals qualify for community Medicaid by placing excess income into a trust managed by a nonprofit, preserving eligibility for home care and other long term services.

Special categories—pregnant women, children, and the essential plan (New York's low-cost health insurance program for those just above Medicaid income limits, linked to the Affordable Care Act)—have their own thresholds, which are adjusted annually.

Income Calculation and Legal Solutions

Don't assume you're ineligible based on net income alone. Social security income, pensions, rental revenue, and investment distributions all factor into the calculation, and solutions like the spenddown program, pooled income trusts, or a monthly income allowance for a community spouse may help. An attorney experienced in Medicaid rules can analyze your specific situation and identify options.

New York Medicaid Asset Limits in 2026: What Counts and What Doesn't

2026 Non-MAGI Asset Limits

For people 65 and older—or anyone applying for long term care Medicaid—New York imposes an asset limit. But not everything you own counts toward that limit.

Applicant Type	Asset Limit (2026)
Single individual	$33,038
Married couple (one spouse applies)	$44,796 combined

New York's asset limit for Medicaid is $33,038 in 2026 for individuals. If your countable assets exceed this amount, you are not eligible until you reduce assets to below the threshold.

Typical Countable Assets

• Cash, checking accounts, savings accounts, and CDs

• Stocks, bonds, and non-retirement brokerage accounts

• Vacation homes, additional real property, and land

• Additional vehicles beyond one primary car

• Certain retirement accounts not yet in payout status

Common Exempt (Non-Countable) Assets

• A primary home, provided you or certain family members live there and equity is within the state's cap (the home equity interest limit is $1,130,000 in 2026)

• One primary vehicle

• Household goods and personal belongings

• Properly structured burial funds and prepaid funeral contracts

• IRAs and 401(k)s in payout status are exempt assets in New York

Asset Conversion and Spend Down

Even if you are currently over the asset limit, legal planning can often convert countable resources into exempt forms or manage them in compliance with Medicaid rules. Applicants with countable resources exceeding the limit may need to spend down their assets to qualify for Medicaid, but there are legitimate ways to do so.

If you're worried about losing savings or a family home in Orange County to nursing home costs, call (201) 466-2641 or message Pedrani Law LLC for a confidential asset review.

Understanding "Countable" vs. "Exempt" Assets for Medicaid

Countable Asset Examples

• Non-retirement brokerage and investment accounts

• Cash value in certain life insurance policies above an allowed threshold

• A vacation property in the Catskills or a second home anywhere

• Additional cars beyond one primary vehicle

• Large cash reserves in bank accounts

Exempt Asset Examples

• A primary home is exempt from Medicaid's asset limit, provided the applicant or qualifying relatives live there and home equity is within the state's limit; intent to return can protect the home from Medicaid claims

• Certain personal belongings and household goods are excluded from countable resources in Medicaid eligibility

• One vehicle is typically exempt from countable assets in New York Medicaid

• Wedding rings and modest jewelry

• Properly set up burial accounts

Special Considerations for Retirement Accounts

Retirement accounts like IRAs and 401(k)s may be treated differently depending on whether the owner is taking required minimum distributions. If they are in payout status, the account value itself may be exempt—but distributions are generally counted as monthly income. Professional advice is crucial, especially for seniors in communities like Goshen, Warwick, and Middletown where retirement accounts often represent the bulk of family savings.

Avoiding Penalties

One critical point: attempting to "hide" assets can trigger penalties and even Medicaid ineligibility. Planning should focus on lawful asset protection strategies that comply with Medicaid's look back period and documentation requirements.

Spousal Protections and the Community Spouse in New York

Community Spouse Resource Allowance (CSRA)

When one spouse enters a nursing home or needs long term care Medicaid and the other continues living in the community, federal and New York law provide spousal impoverishment protections. The goal is to prevent the non-applicant spouse—the "community spouse"—from being left destitute.

Protection	2026 Amount
Maximum Community Spouse Resource Allowance (CSRA)	$162,660
Minimum CSRA	$74,820
Monthly income allowance for community spouse	$4,066.50/month
Family member allowance (per dependent)	$902/month

Asset and Income Protections for the Community Spouse

The community spouse resource allowance allows a non-applicant spouse to keep up to $162,660 in assets. This means that even for a married couple with significant savings, only one spouse applies for Medicaid, and the community spouse may retain a protected share of marital assets.

When only one spouse needs care, the spouse applying for Medicaid must meet strict asset limits, but the community spouse can retain between $74,820 and $162,660 depending on total marital resources. Planning for a married couple often involves re-titling assets, using spousal transfers (which are not penalized under Medicaid rules), and structuring income so the community spouse maintains financial security.

Local Guidance for Couples

Couples in Orange County who are worried that one spouse may need care in a nursing home or adult care facilities should seek a tailored spousal analysis from an elder law attorney such as Keith Pedrani.

The Medicaid Look Back Period and Transfer Penalties

What Is the Look Back Period?

New York has a 60-month Medicaid look-back period for nursing home care. The look-back period reviews asset transfers before the application date. This means Medicaid examines five years of your financial records to see whether you gave away assets or sold property for less than fair market value.

What Triggers a Penalty

• Gifts of cash or property to children or other family members during the 60 months before your application date

• Selling real estate below fair market value

• Sudden large withdrawals from bank accounts that cannot be accounted for

• Adding someone to a deed or account without receiving fair market compensation

Violating the look-back period results in a penalty period of ineligibility. The penalty is calculated by dividing the total uncompensated value of the transfer by the average monthly nursing home cost in your region. For example, if you gifted $150,000 and the regional monthly rate is $15,000, you could face a 10-month penalty period during which Medicaid will not pay for your nursing home stay.

Exceptions and Special Cases

The look-back period does not apply to regular Medicaid (standard health coverage). A 30-month look-back period is planned for community Medicaid, covering home care and certain community-based long term services, though implementation varies.

Not all transfers are penalized. Important exceptions include transfers to a spouse, transfers to a disabled child, and certain "caregiver child" arrangements that must be carefully documented. Because look back rules are complex and errors can be costly, families should consult a Medicaid planning attorney before gifting property or moving large sums—especially if they live in Orange County and foresee possible long term care needs.

Asset Protection Strategies That Comply With New York Medicaid Rules

Medicaid planning does not mean hiding assets. It means using lawful, transparent strategies to protect some resources while still becoming eligible for Medicaid when the time comes.

Properly Timed Gifts and Transfers

• Make gifts and transfers outside the 60-month look back period to avoid penalties.

• Early planning allows for more flexibility and asset protection.

Exempt Transfers

• Transfer assets to a spouse or disabled child, which are not penalized under Medicaid rules.

• Certain "caregiver child" transfers may also be exempt if properly documented.

Permissible Spend-Down

• Spend down assets by paying for medical bills, home modifications, eliminating credit card debt, purchasing a more reliable primary vehicle, or paying burial expenses.

• These expenditures must be for fair market value and properly documented.

Purchasing Exempt Assets

• Upgrade a primary home or prepay funeral costs to convert countable assets into exempt forms.

• Ensure purchases comply with Medicaid rules and are completed before applying.

Irrevocable Medicaid Asset Protection Trusts

• Create and fund an irrevocable Medicaid asset protection trust to shelter a home or investment accounts.

• Trusts must be established and funded well before care is needed and comply with New York's look back rules.

• Be aware that you permanently give up control over assets placed in such trusts.

Combining Strategies

For some families, a combination of Medicaid planning and revocable or irrevocable trust estate planning makes sense, balancing control, tax considerations, and long term care risks.

No strategy guarantees a particular Medicaid eligibility outcome. Results depend on individual facts, changing laws, and how local social services offices apply the rules. That's why professional guidance is essential.

Using Trusts in Medicaid and Estate Planning (Including Revocable Trusts)

Revocable Living Trusts

A revocable living trust allows you to retain full control over your assets during your lifetime. It's an excellent tool for probate avoidance, incapacity planning, and organizing your estate—but it is generally treated as a countable asset for Medicaid purposes. Medicaid views the assets inside a revocable trust as available resources because you can access them at any time.

Irrevocable Medicaid Asset Protection Trusts

An irrevocable Medicaid asset protection trust, by contrast, can remove assets from the Medicaid asset calculation if properly drafted, funded, and allowed to age past the look back period. However, you permanently give up control over those assets. The trust must be structured to comply with New York law and the transfer must occur at least 60 months before any nursing home Medicaid application.

Coordinating Trusts Across State Lines

For clients in Bergen County, New Jersey, Keith Pedrani frequently designs revocable trust-based estate plans that accomplish probate avoidance, family protection, and incapacity planning. When those same clients also have ties to New York—perhaps a home in Orange County or family members there—he can coordinate revocable trust estate planning with separate Medicaid asset protection planning to give families more flexibility.

Families with property in both New York and New Jersey benefit from working with an attorney licensed in both states who understands how trust law, Medicaid rules, and financial products interact across state lines.

Medicaid Planning in Orange County, New York: Local Considerations

Rising Costs and Local Factors

Medicaid and long term care planning is especially pressing for residents of Orange County communities such as Goshen, Warwick, Newburgh, Middletown, and Monroe. Nursing home costs in the Hudson Valley continue to rise, and the cost of home care and personal care services is climbing as well.

County-Specific Practices

Local factors matter. The Orange County Department of Social Services serves as the local New York Medicaid agency for processing and administering Medicaid applications, and practices around documentation and processing can differ from county to county. Regional nursing home costs also affect penalty calculations for improper asset transfers—higher facility costs in the area can mean shorter penalty periods per dollar transferred, but the financial stakes remain significant.

Family and Property Considerations

Many Orange County families have deep ties to their homes, small businesses, or farms. Deciding whether to keep, transfer, or sell a primary residence when a spouse or parent faces nursing home placement is both a financial and emotional decision. Keith Pedrani meets with clients at the Goshen location and can help interpret New York Medicaid rules as they apply locally, including interactions with area hospitals, nursing homes, and home care agencies.

If you live in Orange County and are concerned about Medicaid asset limits or long term care costs, call (201) 466-2641 or contact Pedrani Law LLC to schedule a consultation.

Coordinating Medicaid Planning With a Broader Estate Plan

Integrating Medicaid and Estate Planning

Medicaid asset limit planning should never be done in a vacuum. It must fit into an overall estate plan that addresses wills, trusts, powers of attorney, health care proxies, and beneficiary designations.

Goals of a Coordinated Plan

A well-coordinated plan can accomplish multiple goals:

• Qualify for Medicaid benefits when needed

• Provide for a spouse or disabled child

• Reduce family conflict over inheritance

• Simplify estate administration

• Preserve a legacy for children and grandchildren

• Protect assets from Medicaid's estate recovery program

Essential Tools

Revocable living trusts, durable powers of attorney with strong gifting and trust-creation powers, and updated beneficiary designations are especially important tools when long term care risk is high.

Keith's combined J.D. and M.B.A. from Syracuse University allows him to look not only at legal documents but also at cash flow, retirement accounts, financial products, and tax implications when coordinating Medicaid and estate strategies. If you have an older will or trust, it should be reviewed in light of current New York Medicaid rules and the latest federal poverty level-based Medicaid income limits.

How Attorney Keith Pedrani Helps Families Navigate New York Medicaid

About Keith Pedrani

Keith Pedrani is the founder of Pedrani Law LLC, licensed in New Jersey, New York, and Connecticut. He holds a J.D. and an M.B.A. from Syracuse University, where he graduated magna cum laude. His legal and business background supports a practical, financially informed approach to Medicaid and estate planning.

Key Medicaid and Elder Law Services

• Evaluating Medicaid eligibility and reviewing countable vs. exempt assets

• Designing Medicaid asset protection strategies

• Preparing and filing Medicaid applications

• Advising on long term care options, including nursing home, assisted living, and home care

• Coordinating Medicaid planning with revocable trust estate planning—particularly for Bergen County, NJ clients—as well as wills, powers of attorney, health care proxies, and special needs planning

Keith's practice focuses on clear explanations, realistic expectations (no guarantees of eligibility or asset outcomes), and building step-by-step plans tailored to each family's health, marital status, family dynamics, and financial picture.

To schedule a consultation, call (201) 466-2641 or visit pedranilaw.com to send a secure message.

Common Mistakes When Dealing With Medicaid Asset Limits

Well-intentioned but uninformed decisions can make Medicaid eligibility harder, not easier, and can trigger avoidable penalties or outright Medicaid ineligibility.

Common errors include:

• Giving away large gifts to children or grandchildren within the look back period without legal advice

• Adding children to property deeds without understanding the tax and Medicaid consequences

• Relying solely on internet "rules of thumb" or informal advice from friends and neighbors

• Waiting until a crisis hospitalization to begin planning, when options are most limited

• Failing to coordinate beneficiary designations and joint accounts with the Medicaid plan, leaving assets exposed or passing them in unintended ways

• Assuming that a county Medicaid office will design an asset protection plan for Medicaid applicants—they will not

The safest way to avoid these pitfalls is to consult with a qualified elder law and estate planning attorney before moving assets or filing a Medicaid application.

When to Start Planning: Early vs. Crisis Medicaid Planning

Early Planning

Early planning—five or more years before needing care—gives you the most flexibility and the strongest asset protection options. It allows for strategies like irrevocable Medicaid asset protection trusts and carefully timed transfers outside the 60-month look back period.

Crisis Planning

Crisis planning happens when a loved one is already in a hospital or nursing home and needs Medicaid coverage quickly. There may still be valid strategies to preserve some assets at this stage, but options are more limited and time-sensitive. Spousal protections, partial spend-down, and certain exempt asset conversions may still be available.

Don't Delay

Don't delay if a parent or spouse is starting to need help with daily activities—even if they are still living at home in Orange County or Bergen County. The earlier you begin the conversation, the more you can protect.

Call (201) 466-2641 to discuss whether you should begin proactive Medicaid and estate planning now.

How to Get Started With New York Medicaid and Asset Limit Planning

Getting started doesn't require perfect preparation. Here's a simple process:

1. Gather basic financial information: Collect recent bank statements, property deeds, insurance policies, retirement account statements, and Social Security or pension documentation.

2. List current and anticipated care needs: Determine if the person is still independent, needs help with meal preparation or personal care services, or is facing a possible nursing home admission.

3. Identify family decision-makers: Clarify who has power of attorney and who is involved in care decisions.

4. Schedule an initial consultation: During the meeting, Keith will review income, assets, existing estate planning documents, and family goals to determine Medicaid eligibility or what changes are needed.

5. Prepare for next steps: Possible actions may include drafting or updating wills and trusts, preparing powers of attorney, restructuring ownership of certain accounts, or preparing a Medicaid application with supporting documentation.

You do not need everything perfectly organized to schedule a meeting. Bringing recent statements and prior estate planning documents is a strong start.

Contact Pedrani Law LLC at (201) 466-2641 or through the firm's website to begin the conversation.

Frequently Asked Questions About New York Medicaid Asset Limits

These FAQs address common follow-up questions that go beyond the main discussion above. If your situation is more complex, a consultation with an elder law attorney can provide clarity.

Does my primary home always count toward the New York Medicaid asset limit?

In many cases, a primary residence is treated as an exempt resource if the applicant—or certain relatives such as a spouse or disabled child—lives there and the home's equity is under the state-set cap. The home equity interest limit is $1,130,000 in 2026, and the applicant must express intent to return home if they are in a facility. However, Medicaid's estate recovery program can claim the home after death to reimburse Medicaid for long term care costs paid on the recipient's behalf. If no spouse or qualifying relative remains in the home, or if the property is used primarily as a rental or vacation house, Medicaid may treat it differently. Personalized legal advice is important to understand your exposure.

Can I keep my IRA or 401(k) and still be eligible for New York Medicaid?

Treatment of retirement accounts depends on whether they are in "payout status." IRAs and 401(k)s in payout status—meaning required minimum distributions have begun—are generally considered exempt assets in New York. However, the distributions themselves count as monthly income. If the account is not yet in payout status, the full value may be treated as a countable asset. Because retirement accounts often represent a large share of family savings, Medicaid applicants should speak with a Medicaid planning attorney before making withdrawals, rollovers, or conversions.

What happens if my income is over the Medicaid income limit but my assets are within the limit?

New York may still allow you to become Medicaid eligible even if your income is over the limit through the Medicaid excess income program, sometimes called a "spenddown." Under this approach, the applicant pays their excess income toward medical costs each month, which is often especially important for people facing high medical bills. For some disabled or older adults, a pooled income trust can manage excess income while maintaining eligibility for home care or community Medicaid. Eligibility and program availability depend on your age, disability status, marital status, and where you live, so careful budgeting and professional guidance are essential to avoid interruptions in Medicaid coverage.

Will Medicaid take all of my assets after I die?

Medicaid does not take your assets while you are alive, but after a Medicaid recipient's death, New York's estate recovery program can seek reimbursement from the probate estate for long term care costs paid on the recipient's behalf. Proper estate planning—through trusts, beneficiary designations, and ownership structuring—can sometimes reduce the impact of estate recovery. There are no guarantees, and laws can change. Working with an attorney to structure your plan is the most effective way to address this risk.

Is it ever too late to do Medicaid planning?

While more options are available with earlier planning, there is almost always something that can be done—even if a person is already in a nursing home or hospital. Limited asset repositioning, spousal strategies, and partial preservation of available resources may still be possible. Don't assume it's too late. If you live in Orange County, New York, and face immediate long term care decisions, seek a prompt legal review from an experienced Medicaid planning attorney. Call Pedrani Law LLC at (201) 466-2641 or reach out online today.