When a parent or spouse in New York needs nursing-home care, New York Medicaid can pay for it once the person meets the state's asset and income rules. The state reviews gifts made in the 60 months before applying. It protects a set amount of savings and income for a spouse at home. After death, it can seek repayment from the estate.
A family in New York can reach these rules in the middle of something hard. A father may have just moved from a hospital in Brooklyn to a rehabilitation floor and is not going home. A wife in Nassau County may be lying awake over whether the house and the savings will still be there for her. Common questions are what the program counts, what it leaves alone, and whether a gift to a grandchild three years ago will cause trouble. This page sets out New York's 2026 figures and rules, with the year each applies to.
What New York Medicaid Covers for Long-Term Care
New York Medicaid is run by the New York State Department of Health. Local departments of social services decide individual cases. Medicaid itself is a joint federal and state program. The federal government describes it that way and notes that states may choose to cover additional groups, "such as individuals receiving home and community-based services." Federal law, mainly 42 U.S.C. § 1396p and 42 U.S.C. § 1396r-5, sets the framework. New York applies that framework with its own figures. Federal rules and New York rules are therefore not interchangeable.
Two settings matter for long-term care:
- Nursing facility services. This is care in a nursing home, often called institutional Medicaid.
- Community-based long-term care. This is care at home. In New York it is often delivered through the Managed Long-Term Care program. The state's 2026 levels message refers to that program by name.
The rules on this page apply statewide. That includes the five boroughs of New York City, Long Island's Nassau and Suffolk counties, Westchester and Rockland, and the upstate counties. What differs by region is the transfer-penalty rate.
Throughout this page, a countable asset is an asset Medicaid counts toward its resource limit. An exempt asset is one it does not count. This page covers Medicaid for long-term care only. It does not cover Medicare, private long-term-care insurance or veterans' benefits.
New York Medicaid Eligibility: Asset and Income Rules
New York's figures for 2026 come from the Department of Health's GIS 26 MA/03, effective January 1, 2026.
Married couples. A community spouse is the husband or wife who stays at home while the other spouse receives nursing-facility care. The federal spousal-impoverishment rules in 42 U.S.C. § 1396r-5 work as follows:
- When the application is made, the resources of both spouses are generally treated as available to the spouse in care.
- An exception applies for the amount protected for the spouse at home. This protected amount is the community spouse resource allowance (CSRA).
For New York, effective January 1, 2026:
| Allowance | 2026 figure |
|---|---|
| Maximum federal CSRA | $162,660.00 |
| Minimum state CSRA | $74,820.00 |
| Community spouse monthly income allowance (up to) | $4,066.50 |
The state's March 2026 Medicaid Update gives the community spouse monthly income allowance as "an amount of up to $4,066.50 a month for 2026," effective January 1, 2026. GIS 26 MA/03 lists the same $4,066.50 as the community spouse Minimum Monthly Maintenance Needs Allowance (MMMNA).
The Information Notice to Couples in the state's March 2026 Medicaid Update defines the "spousal share" for purposes of the allowance calculation:
- It is one-half of the couple's total countable resources.
- It is measured at the beginning of the most recent continuous period of institutionalization.
- The calculation does not count the home, household items, personal property, the car, or certain funds set aside for burial.
The same Update notes that spousal impoverishment rules do not apply to an institutionalized spouse who is eligible under the Modified Adjusted Gross Income rules. The married couples rules page covers the federal framework in more depth.
Income in a nursing home. How much of the resident's monthly income goes toward the cost of care depends on New York's current rules.
The New York Medicaid Look-Back Period
The look-back period is the window before an application during which the agency reviews transfers of assets.
The federal rule. Under 42 U.S.C. § 1396p(c)(1)(B)(i), the federal look-back is 60 months for any transfer made on or after February 8, 2006.
New York's rule for nursing-home care. New York's How to Apply page states that "the 'lookback' period is 60 months (5 yrs) prior to the month you are applying for coverage of nursing home care." The state's Medicaid Reference Guide states that the look-back period increased from 36 months to 60 months for transfers made on or after February 8, 2006. The period was phased in from 36 months, and "effective February 1, 2011, the full 60 month look-back period will be in place for ALL transfers of assets."
Home care. The look-back for community-based home care depends on New York's current rules.
How a penalty is calculated. A penalty period is a stretch of months when Medicaid will not pay for nursing-facility care because of a transfer for less than fair market value. The Reference Guide sets out the calculation:
- The penalty in months equals the uncompensated value of what was transferred, divided by the average regional rate for the region where the person is in a facility.
- There is no cap on the length of the penalty period.
- The rate used is the one in effect on the date of application, for the region where the facility is located.
GIS 25 MA/14 sets the 2026 regional nursing home rates used to calculate a transfer penalty period. Rates for five of the seven regions are:
| Region | Counties named | 2026 monthly rate |
|---|---|---|
| New York City | Bronx, Kings, New York, Queens, Richmond | $15,282 |
| Long Island | Nassau, Suffolk | $15,193 |
| Northern Metropolitan | Includes Westchester, Rockland, Orange | $15,024 |
| Rochester | Includes Monroe | $15,675 |
| Central | Includes Onondaga | $14,146 |
When a penalty starts. Federal law starts the penalty on the later of two dates: the first day of a month during or after which assets were transferred, or the date the person is eligible and would otherwise be receiving institutional-level care but for the penalty (42 U.S.C. § 1396p(c)(1)(D)(ii)). New York's Guide starts it on the first day of the month after the transfer, or the first day of the month the otherwise eligible person is receiving nursing facility services for which Medicaid would be available but for the transfer penalty, "whichever is later."
Exceptions. A transfer to the person's spouse carries no transfer penalty (42 U.S.C. § 1396p(c)(2)(B)(i)). Other exceptions exist. Which ones apply depends on the facts and on current New York rules.
Protecting the Family Home in New York
A house in Queens, a co-op in Manhattan, or a long-held home in Suffolk County is often the largest asset in the family. It is also the one families worry about most.
While it is the primary residence. New York's Reference Guide states that a homestead is exempt "as long as it is the primary residence" of an SSI-related applicant or a family member. It stays exempt during a temporary absence. When the applicant is away from home, it is not counted "as long as the A/R indicates an intent to return home (regardless of the individual's actual ability to return home)."
The home-equity limit. Federal law sets a ceiling. Under 42 U.S.C. § 1396p(f), long-term-care coverage is barred when home equity is above a set limit. The limit does not apply if the person's spouse, or a child under 21 or a child who is blind or permanently and totally disabled, is lawfully residing in the home. New York's limit for 2026 is $1,130,000.00, for both nursing facility services and community-based long-term care, according to GIS 26 MA/03.
After death: estate recovery. Estate recovery is the state's claim against a deceased Medicaid recipient's estate to recover care costs it paid. Section 369 of New York's Social Services Law provides that recoveries must be pursued from the estate of an individual who was 55 or older when he or she received assistance. For individuals whose eligibility was based on paragraph (b) of subdivision one of section 366 of that law, recovery is limited to medical assistance consisting of nursing facility services, home and community-based services, and related hospital and prescription drug services. For purposes of section 369, "estate" means all real and personal property and other assets included within the individual's estate and passing under the terms of a valid will or by intestacy.
Deferral and hardship waivers. Under section 369, an adjustment or recovery is made only after the death of the individual's surviving spouse, if any, and only at a time when the individual has no surviving child who is under 21 or is blind or permanently and totally disabled. Federal law has the same deferral (42 U.S.C. § 1396p(b)(2)). The deferral delays the claim. It does not cancel it. Section 369 also provides that its recovery requirements "shall be waived in cases of undue hardship," as determined under the Department's regulations, and federal law requires States to have such procedures (42 U.S.C. § 1396p(b)(3)).
Medicaid Planning Tools Available Under New York Law
Several tools come up in New York Medicaid planning. Each one works within the rules above. None is right for every family, and none can be relied on to produce a particular result.
- Transfers between spouses. These carry no transfer penalty. Separately, 42 U.S.C. § 1396r-5(f) lets the spouse in care transfer the CSRA amount to, or for the sole benefit of, the community spouse. It also exempts transfers made under a court order for the community spouse's support.
- Irrevocable Medicaid asset protection trusts. Assets are placed in a trust the person cannot revoke. New York's Reference Guide treats any portion of the principal of an irrevocable trust, and the income from it, from which no payments may be made to or for the benefit of the applicant or the applicant's spouse as an asset transfer when the trust was established on or after August 11, 1993, and it applies a 60-month look-back to trusts. Whether a particular trust's assets are counted depends on its terms.
- Spousal refusal. New York's Information Notice to Couples includes a section titled "Spousal Refusal and Undue Hardship Concerning a Community Spouse's Refusal to Provide Necessary Information." The Notice states that refusal to provide the necessary information "shall be reason for denying Medicaid for the institutionalized spouse," subject to its undue hardship provisions, and that the Department of Health or the local department of social services may refer the matter to court for recovery from the community spouse of any Medicaid expenditures for the institutionalized spouse's care.
The planning after nursing home admission page covers which choices remain open once care has begun. Whatever tool a family considers, every asset and every transfer has to be reported on the application.