Client Resources

⚠️ Looking for the updated limits? See our guide to the
2026 New York Medicaid Income and Asset Limits..

Income Eligibility and Resource Allowance

Every person’s estate plan must consider the eventual need for elder care, including arrangements for long-term care. Many New Yorkers will need to turn to Medicaid for help paying the high cost of residential nursing home care, either for themselves or for family members. Preserving your assets while remaining eligible for Medicaid’s help requires planning for future needs as early as possible.

New York State has just published its updated 2025 Medicaid income eligibility and resource allowance levels. These figures are effective as of January 1, 2025, and include significant changes you should be aware of. This article explains the key changes and discusses how these new thresholds and limits may affect your Medicaid benefits.

At Ely J. Rosenzveig & Associates, we have years of experience integrating sound elder care plans into each estate plan we draft. When planning for Medicaid, one of our key objectives is preserving your wealth and protecting your assets from Medicaid look-back while ensuring you qualify for coverage when you need it. Planning early is essential. Call us to discuss your situation and plan for your family’s future.

What Are NY’s 2025 Medicaid Income and Resource Eligibility Caps?

New York Medicaid distinguishes between benefit recipients who live in institutional settings, such as nursing homes, and those who continue to reside in community-based facilities or at home. The 2025 updated income eligibility and resource limits for institutional Medicaid applicants and recipients are as follows:

2025 NY Nursing Home (Institutional) Medicaid Asset Resource Limits

• Single Individual Asset Resource Allowance limit: $32,396
• Married couple Asset Resource Allowance (both applying): $43,781
• Community Spouse Maximum Resource Allowance: $157,920
  

While a Medicaid applicant seeking institutional or nursing home care is limited to only $32,396 in retained assets to remain eligible, the applicant’s spouse living in the community is entitled to retain 50% of the couple’s joint assets up to $157,920 in financial assets. If half of the total assets is less than $74,820, then the community spouse may keep 100% of the resources up to $74,820.

The reason community spouses are allowed to retain financial resources when a spouse is receiving Medicaid nursing home benefits is to ensure they do not become destitute by stripping them of sufficient funds to house and support themselves.

Home Exemption

This figure does not include the marital home or primary residence of the parties. In New York, a spouse’s principal residence (or that of the Medicaid applicant if planning to return home) is exempt from Medicaid up to a maximum of $1,097,000 of equity.

Nursing Home (Institutional) Medicaid Income Limits

• Income allowance for applicants/recipients of nursing home benefits: $50 per month
• Community spouse Minimum Monthly Maintenance Needs Allowance: $3,948 per month
  

As might be expected, the government permits those receiving Medicaid benefits covering their nursing home expenses to retain only enough monthly income to pay for needed personal care items and little else. An exception applies for those benefit recipients who spend excess income on uncovered necessary treatment, supplies, or other disability related items.

As noted above regarding a community spouse’s resource allowance, Medicaid also allows the non-applicant spouse to retain up to $3,948 in monthly income without being asked to contribute to their spouse’s nursing home costs. When a community spouse’s income exceeds that sum, Medicaid can request that up to 25% of the excess be paid to offset some of Medicaid’s spending for the institutionalized spouse.

Spousal Refusal

However, the community spouse of a Medicaid applicant seeking or receiving nursing home care is not legally obliged to contribute to the cost of that care. The community spouse may initiate a procedure called Spousal Refusal, denying the government’s request that they contribute to their spouses nursing home care costs.

Spousal Refusal is initiated by filing specific declarations with Medicaid at the time the spouse needing care applies for coverage. Any person considering Spousal Refusal should consult with an experienced Medicaid planning lawyer to ensure the procedure is executed properly. The elder law attorneys at Ely J. Rosenzveig & Associates will provide you with reliable guidance through this process as they have for many others over the years.

Spousal Refusal may sound hard-hearted to some, but the purpose of denying Medicaid’s initial demand for contribution often makes economic sense. While the government is entitled to file a lawsuit against a community spouse who exercises Spousal Refusal, such a suit is not guaranteed. If a lawsuit is filed and prevails against the community spouse, that spouse will only need to pay the substantially reduced costs paid by Medicaid for their partner’s care rather than the 30% to 40% higher prices they would have paid privately for the same care.

2025 Home Care (Community) Medicaid Income and Resource Limits

New York Medicaid also provides benefits to support home and community-based care for people whose needs do not require institutional care. As with Medicaid benefits extended to applicants seeking nursing home coverage, benefits offered to New Yorkers seeking community-based care require that applicant’s meet strict income and resource criteria:

• Individual Applicant Resource Allowance for Home Care: $32,396
• Married couple (both applying) Resource Allowance for Home Care: $43,781
• Single Home Care Applicant Income Allowance: $1,800 / month
• Married Home Care Applicants (both applying) Income Allowance: $2,433 / month
  

New Yorkers needing home or community-based care are also subject to denial of benefits if their financial resources and/or monthly income exceeds the new 2025 guidelines.

Medicaid’s 5-Year Look-Back (and Upcoming 30-Month Look-Back)

Whether planning for healthcare needs in one’s elder years or preparing for an unexpected incapacity due to illness or injury, advance planning is key to ensuring that valuable individual or family resources are preserved while also enabling those who need to care to seek Medicaid assistance to pay ever-rising costs. No one knows when sudden health issues may require skilled nursing in an institutional setting.

Medicaid enforces a 5-year look-back period to ensure that applicants have not disposed of valuable assets in anticipation of their Medicaid claim. Any transfer of assets for less than fair market value made in the five years preceding the submission of an application results in Medicaid imposing a penalty period of ineligibility. Currently, this 5-year look-back period only applies to applications for nursing home or institutional care benefits. However, Medicaid plans to impose a 30-month look-back period on community-based applicants as well, perhaps sometime in 2025 (whether this 30-month look-back period is implemented this year, next year, or at all, remains unclear at the moment).

Ely J. Rosenzveig & Associates Medicaid Planning Attorneys Can Help

New York Medicaid income eligibility and resource allowance guidelines are complicated by the frequent policy updates and by exceptions to the general rules that can allow applicants’ income to be discounted due to high uninsured medical expenses or other exempted obligations.

The elder law and Medicaid planning attorneys at Ely J. Rosenzveig & Associates have preserved the hard-earned assets of thousands of clients by understanding New York State and federal trust and estate planning law and regulations.

Don’t delay planning to protect your financial assets. Contact the knowledgeable elder law and Medicaid planning lawyers at Ely J. Rosenzveig & Associates today.

New York’s Elder Law and Medicaid Planning Law Firm
Contact Ely J. Rosenzveig & Associates:
Call 1.914.816.2900 or email us at: info@ejrosenlaw.com