The Staggering Reality of Long-Term Care Costs in New York: Your Financial Future Depends on Taking Action Today

New York residents face some of the highest long-term care costs in the nation, creating a financial crisis that threatens to devastate family savings and leave loved ones without the quality care they deserve. In New York, just one year of care in a nursing home costs, on average, approximately $159,000 per person, while home care across the state in New York on average costs $27 an hour in 2024 per the Genworth Cost of Care Survey. These astronomical expenses underscore the urgent need for comprehensive asset protection planning before it’s too late.

The Current Landscape of Long-Term Care Costs

The financial burden of long-term care in New York extends far beyond nursing home expenses. In 2024, according to Genworth’s Cost of Care Survey, the average cost of assisted living in New York is $5,850 a month, while non-residential adult day care in New York continues to be the least expensive care option and costs on average $105 per day in 2024. These costs vary significantly across the state, with some regions experiencing even higher rates that can quickly exhaust a lifetime of savings.

The situation becomes more complex when considering Medicaid eligibility requirements. In 2025, a single Nursing Home Medicaid applicant must meet the following criteria: 1) Income under $1,800 / month 2) Assets under $32,396 3) Require a Nursing Home Level of Care. For many middle-class families, these strict limitations mean that significant financial planning is essential to protect their assets while ensuring access to necessary care.

Strategic Asset Protection Solutions

Fortunately, New York offers several sophisticated strategies to protect assets from long-term care costs. The most effective approaches require advance planning and professional guidance to implement properly.

The New York State Partnership for Long-Term Care

The NYS Partnership for Long-Term Care (NYSPLTC) is a unique Department of Health program combining private long-term care insurance and Medicaid Extended Coverage (MEC). Its purpose is to help New Yorkers financially prepare for the possibility of needing nursing home care, home care, or assisted living services someday. The program works by allowing an individual or couple who purchases a Partnership insurance policy and keeps in effect to hold onto all or part of their assets (depending on the type of policy purchased) under the Medicaid program if their long-term care needs extend beyond the period covered by their policy.

This program offers significant advantages, including the “protected” assets are safe from Medicaid’s Estate Recovery Program (MERP), the program through which Medicaid attempts reimbursement of long-term care costs following the death of a Medicaid beneficiary.

Medicaid Asset Protection Trusts (MAPTs)

A popular strategy to protect your resources and still become eligible for Medicaid long term care benefits is by establishing a Medicaid Asset Protection Trust (MAPT). When you transfer your assets in a MAPT, Medicaid will not count the money in the trust toward its resource limit. However, timing is crucial. The federal lookback period for Medicaid long term care is five years prior to the application. New York imposes a five year lookback for nursing home care, and while they recently imposed a 30 month lookback for community care.

These trusts provide dual benefits: these trusts protect a Medicaid applicant’s assets from being counted for eligibility purposes, as assets put into this type of trust are no longer considered owned by them. They also protect assets for one’s children and other relatives, which is a win-win for Medicaid applicants and their families.

The Importance of Professional Legal Guidance

Given the complexity of New York’s Medicaid laws and the severe financial consequences of inadequate planning, working with experienced legal professionals is essential. It is crucial that it is established and administered under the close guidance of an elder law attorney that is familiar with these trusts as well as the Medicaid long term care eligibility process. In addition, there are situations where this planning is not necessarily the right strategy and therefore, as with any legal strategy, your particular situation, including the risks and benefits, should be carefully reviewed by an elder law attorney before proceeding.

For families in Suffolk County seeking expert guidance, consulting with an experienced Estate Planning Attorney Suffolk County can make the difference between preserving family wealth and losing everything to long-term care costs. Fratello Law, with offices in both Nassau and Suffolk Counties, has built a reputation as a trusted advisor to Long Island families navigating these complex challenges.

Additional Asset Protection Strategies

Beyond trusts and insurance, several other strategies can help protect assets:

• Long-Term Care Insurance: According to the 2024 American Association for Long-Term Care Insurance (AALTCI) annual Price Index survey, the average annual premium for a $165,000-benefit policy with no inflation protection is $950 for a single male (age 55) and $1,500 for a single female (age 55). For a couple where both are age 55, the average combined annual premium is $2,080.
• Spousal Protection Strategies: In 2025, the CSMIA is $3,948. If the non-applicant spouse has monthly income under this amount, they can receive income from their applicant spouse to bring their monthly income up to this amount.
• Home Equity Protection: If there is no spouse in the home, there is a home equity interest limit of $1,097,000 (in 2025).

The Cost of Waiting

The most expensive mistake families make is waiting too long to begin planning. Planning well in advance of the need for long-term care Medicaid is the best course of action when considering a Medicaid Asset Protection Trust. MAPTs are not suitable for persons who need Medicaid immediately or within a short period. This is because MAPTs are a violation of Medicaid’s Look-Back Period if not set up at least 5 years before one applies for long-term care Medicaid.

With long-term care costs continuing to rise and Medicaid rules becoming increasingly complex, the window for effective asset protection planning narrows each year. Families who take proactive steps today can preserve their wealth for future generations while ensuring access to quality care when needed.

Taking Action

The rising costs of long-term care in New York represent a clear and present danger to family financial security. However, with proper planning and professional guidance, families can protect their assets while ensuring access to necessary care. The key is to start planning now, before a health crisis makes it too late.

Whether through Partnership insurance policies, Medicaid Asset Protection Trusts, or other sophisticated strategies, the tools exist to safeguard your family’s financial future. The question isn’t whether you can afford to plan—it’s whether you can afford not to.