Medicaid Planning Attorneys in Westchester County, New York
Whether you are planning ahead or arranging care now, Medicaid eligibility and timing can affect your options. Our attorneys help Westchester families review assets, income, and care needs, then identify the planning or application steps that fit their situation. Meet in Tarrytown by appointment, or by video or phone.
Medicaid planning is the lawful process of arranging your assets, income, and legal documents so that you or a loved one qualifies for New York Medicaid nursing home or home care benefits while your home and savings are preserved for your spouse and children. From our Westchester County office in Tarrytown, the elder law attorneys of Milvidskiy Law Group P.C. represent families throughout the county.
In Westchester, eligibility is determined by the Westchester County Department of Social Services (DSS), and nursing home applications are handled by its Institutional Assistance Unit in Mount Vernon. Transfer penalties are calculated using the Northern Metropolitan regional rate, and Medicaid home care is delivered through Managed Long Term Care plans serving the county. Knowing how these local pieces fit together is as important as knowing the statewide rules.
Key Takeaways:
- New York’s rules apply uniformly in Westchester, but the county’s home values, retirement savings, and care costs mean that the home equity limit, the spousal resource allowance, and the regional penalty rate shape almost every plan.
- Nursing home Medicaid carries a 60-month look-back. Home care Medicaid currently carries none, so Westchester families who want to age at home have an opportunity that may not last.
- Married couples in Westchester may be able to preserve assets above the standard allowance through spousal refusal, and single applicants often have meaningful options even after a nursing home admission.
What Makes Medicaid Planning in Westchester Different
High Home Values and the Equity Limit
A primary residence is exempt for New York Medicaid while the applicant or a spouse lives there, but a single applicant whose equity exceeds $1,130,000 in 2026 is ineligible for long-term care benefits unless a spouse or a minor, blind, or disabled child lives in the home. Across much of New York that limit is rarely reached. In much of Westchester, it is routine. For these homeowners the planning question is not whether the home is exempt today, but how to move it beyond the reach of the equity rule, the spend-down, and the estate recovery claim before care is needed, usually through a Medicaid Asset Protection Trust.
The Northern Metropolitan Regional Rate
When a Westchester resident enters a nursing home after making gifts within the 60-month look-back, the penalty period is calculated by dividing the gifts by the regional rate for the region where the facility is located. For 2026, the Northern Metropolitan rate covering Westchester, Rockland, Putnam, Orange, Dutchess, Sullivan, and Ulster Counties is $15,024 a month. A $150,000 gift, for example, produces a penalty of roughly ten months. Because actual private-pay rates at many Westchester facilities exceed the regional rate, the true cost of a penalty month is often higher than the formula suggests, which makes precise crisis planning essential.
Substantial Retirement Accounts
Westchester households frequently hold the bulk of their savings in IRAs and 401(k) accounts. New York does not count a retirement account that is in payout status, and as of 2026 the district may no longer require the account holder to take the maximum periodic payment. For many Westchester applicants, placing retirement accounts in payout status is one of the most important steps in the plan, because it can keep a large account from being counted without any transfer or penalty.
Families on Both Sides of the State Line
Westchester borders Connecticut, and many county residents have children in Connecticut, New Jersey, or New York City, own a second home in another state, or plan to relocate near family. Trusts, powers of attorney, and deeds must satisfy New York Medicaid rules while functioning across state lines, and a plan built for New York may need to anticipate Connecticut’s far stricter rules if a move is possible. We help New York clients coordinate an estate plan with property and family interests in other states. When another state’s law or local work is involved, we identify the additional legal assistance needed.
New York Medicaid Rules That Every Westchester Applicant Must Meet
Regardless of municipality, the core financial rules are the same. For 2026, a single applicant may keep $33,038 in countable resources and a couple applying together may keep $44,796. A nursing home resident pays nearly all monthly income to the facility, keeping a $50 personal needs allowance and any allowance payable to a spouse at home. A community Medicaid recipient may keep $1,836 a month, with surplus income directed to a pooled income trust. Without spousal refusal, the spouse at home may keep between $74,820 and $162,660 in resources and up to $4,066.50 a month in income. Nursing home applicants must document 60 months of finances; home care applicants currently face no look-back.
Planning Options by Situation
The right New York Medicaid strategy depends on your timeline, your marital status, and whether you want care at home or in a facility. Select the situation closest to yours.
You want to stay in your Westchester home and receive care there
New York Medicaid pays for home care through Managed Long Term Care (MLTC) plans, and Westchester residents may hire a family member or friend as a paid caregiver through the Consumer Directed Personal Assistance Program (CDPAP). Because community Medicaid currently has no look-back, excess resources can be transferred to a Medicaid Asset Protection Trust or to family and an application filed without a waiting period. Surplus income above the $1,836 allowance is deposited into a pooled income trust and used for your household expenses. Eligibility also requires a functional assessment through the New York Independent Assessor, which applies a minimum needs standard for new applicants. We handle the financial application with Westchester DSS, the disability determination and pooled trust enrollment, and coordination with the MLTC plan so that care can start as quickly as the process allows.
Your spouse needs nursing home care now
Westchester couples have two paths. Under the standard spousal impoverishment rules, the spouse at home keeps the Community Spouse Resource Allowance and a monthly income allowance, and excess assets are repositioned through exempt purchases, debt payoff, and transfers of the home. Under spousal refusal, the community spouse signs a written refusal to contribute, and Westchester DSS must evaluate the applicant on his or her own resources alone, which may allow the couple to preserve assets above the allowance. The district retains the right to seek contribution from the refusing spouse, and we advise on that exposure and negotiate when the county pursues it. The spousal asset assessment is fixed as of the first day of continuous institutional care, so the earlier we are involved, the more options remain.
You are single and entering a nursing home without prior planning
Even without advance planning, a single Westchester applicant may have options to preserve a portion of savings. The gift and promissory note strategy, sometimes called half-a-loaf, gifts roughly half of the excess assets and lends the remainder under a compliant promissory note whose payments cover the nursing home during the penalty period calculated at the Northern Metropolitan rate. Retirement accounts are placed in payout status. A home-transfer exception may apply to a child who lived in the home for at least two years immediately before the parent’s institutionalization and provided care that allowed the parent to remain at home. A sibling exception requires an equity interest and residence in the home for at least one year immediately before institutionalization. Documentation and the full eligibility rules matter. Other home-transfer exceptions may also apply, including certain transfers to a spouse or a child who is under 21, blind, or disabled. Prepaid funeral arrangements, home repairs, and debt payoff convert countable resources into exempt ones. Each step must be calculated against the facility’s actual rate and the applicant’s income.
You own a high-value home and want it to stay in the family
A Medicaid Asset Protection Trust is designed to remove the home from your countable resources, take it out of the home equity calculation, and keep it outside the probate estate that New York’s estate recovery can reach. You retain the right to live in the home for life, keep your STAR and senior property tax exemptions, and generally preserve the capital gains exclusion and the step-up in basis for your children. The transfer starts the 60-month clock for nursing home Medicaid and, under current rules, supports a home care application immediately. A life estate deed to children is a simpler alternative that we sometimes recommend, but it exposes the remainder interest to the children’s creditors and complicates a sale during your lifetime.
You have a second home or investment property
Real estate other than your residence is a countable resource. Westchester families with a house upstate, a condominium in Florida, or a rental property face a choice among transferring the property to an irrevocable trust more than five years before nursing home care, selling and repositioning the proceeds, or using rental income to fund a caregiver agreement or pooled trust. Out-of-state property raises additional questions of ancillary probate and the other state’s Medicaid rules. We coordinate all of it in one plan.
You are already paying for a parent’s care
Adult children in Westchester often begin managing a parent’s money, covering bills, or providing hands-on care long before anyone considers Medicaid. Keep records of payments between family members. Gifts, loans, reimbursements, and payments for care can receive different Medicaid treatment. Before moving money or reimbursing a caregiver, review the purpose, documentation, and effect on the applicant’s income and resources. Care provided by a child should be compensated only under a written caregiver agreement signed before services begin, at an agency-comparable rate, with time records kept. Reimbursements should be documented. We review what has already happened, address any exposure, and put compliant arrangements in place before the application is filed.
You have more than five years before care is likely
With time, the full range of New York tools is available at the lowest cost. A Medicaid Asset Protection Trust funded with the home and a portion of investments starts the 60-month clock while you keep the income. Your power of attorney should expressly authorize any gifting or trust transactions your plan may require. Under the current statutory short form, additional gifting authority is stated in the Modifications section. We also review older documents and any valid gift rider. Beneficiary designations, joint accounts, and existing revocable trusts are reviewed so that nothing undoes the plan, and long-term care insurance is coordinated with the Medicaid strategy. Planning early gives Westchester families the widest range of options and the greatest opportunity to preserve what they own.
Applying for Medicaid Long-Term Care in Westchester County
Westchester residents age 65 and older, and those with disabilities, apply for Medicaid through the Westchester County Department of Social Services rather than the state marketplace. The county’s main office is at 148 Martine Avenue in White Plains, and nursing home eligibility is determined by the Institutional Assistance Unit at 100 East 1st Street, 6th Floor, Mount Vernon. Staff at many Westchester hospitals and nursing homes are trained to conduct eligibility interviews on site for residents who are already admitted.
A nursing home application requires 60 months of statements for every account, records of closed accounts, deeds and mortgage statements, life insurance and annuity contracts, retirement account statements, income verification, and written explanations for significant withdrawals and transfers. The Institutional Assistance Unit issues requests for additional documentation with short deadlines, and an incomplete response results in denial. For a Westchester family paying private rates, each month of delay costs $15,000 or more. We assemble and file the application, respond to every county request, coordinate with the facility’s business office, and represent clients at fair hearings when the county miscalculates a penalty, an allowance, or a resource.
Protecting the Estate After Death
New York recovers Medicaid benefits paid to a recipient age 55 or older only from the probate estate, which in Westchester is administered in the Westchester County Surrogate’s Court in White Plains. Assets held in a properly drafted trust, jointly owned property, accounts with named beneficiaries, and homes passing under a retained life estate are generally outside the probate estate and beyond the county’s reach. Recovery is deferred while a surviving spouse or a minor, blind, or disabled child is living and may be waived for hardship. Because the definition is narrow, the difference between a home held in the recipient’s sole name and a home held in trust is often the difference between losing the home and keeping it.
Working With Milvidskiy Law Group P.C. in Westchester County
We meet with clients at our Tarrytown office in Westchester County, by video conference, and by phone, and we coordinate with the hospital discharge planners, nursing facility admissions staff, geriatric care managers, and financial advisors who are part of a family’s care team. Our elder law attorneys handle New York Medicaid planning from the first consultation through trust funding, application, approval, and, where needed, fair hearings. If you live elsewhere in New York State, please see our Medicaid Planning in New York page.
Meet with our team at 120 White Plains Road, Suite 420, Tarrytown, NY 10591, by appointment. Video and phone meetings are also available.
This page is provided for general informational purposes only and does not constitute legal advice. Medicaid figures are adjusted annually and rules change. For advice about your situation, consult a qualified attorney.
Frequently Asked Questions
Where do I apply for nursing home Medicaid in Westchester County?
Nursing home Medicaid eligibility in Westchester is determined by the Westchester County Department of Social Services Institutional Assistance Unit at 100 East 1st Street, 6th Floor, Mount Vernon, NY 10550. The county’s main DSS office is at 148 Martine Avenue in White Plains. Many Westchester hospitals and nursing homes have staff trained to conduct eligibility interviews on site. Our office prepares and files the application and handles the county’s follow-up requests.
Which regional rate applies to Westchester County Medicaid transfer penalties?
Westchester is in New York’s Northern Metropolitan region, along with Rockland, Putnam, Orange, Dutchess, Sullivan, and Ulster Counties. For 2026, the Northern Metropolitan regional rate is $15,024 a month. The total value of gifts made during the 60-month look-back is divided by this rate to determine the number of months of ineligibility for nursing home Medicaid.
My home in Westchester is worth more than $1,130,000. Can I still qualify?
Possibly. The home equity limit does not apply when a spouse or a minor, blind, or disabled child lives in the home. For a single homeowner, one solution is to transfer the home to a Medicaid Asset Protection Trust, which is designed to remove it from the equity calculation and from countable resources. Because home care currently has no look-back, the trust can support a home care application right away; nursing home protection follows after 60 months.
Can my spouse refuse to pay for my nursing home care in Westchester?
Yes. New York permits spousal refusal under Social Services Law § 366(3)(a). If your spouse signs a written refusal, Westchester DSS must determine your eligibility based on your own income and resources. Your spouse must still disclose his or her finances, and the county may later seek contribution under an implied contract. Whether to use spousal refusal, and how to respond if the county pursues recovery, are decisions we make with you based on your circumstances.
Does Medicaid pay for home care in Westchester County?
Yes. Medicaid home care in Westchester is delivered through Managed Long Term Care plans, and eligible recipients can hire a family member or friend as a paid caregiver through CDPAP. Financial eligibility is determined by Westchester DSS and functional eligibility through the New York Independent Assessor. As of this writing, community Medicaid has no look-back, so transfers can be made and an application filed without a penalty period.
How much does a nursing home cost in Westchester County?
Private-pay rates at Westchester County nursing homes commonly range from $15,000 to $18,000 a month, and some facilities charge more. At these rates, even substantial savings can be exhausted within a few years, which is why families with significant assets plan for Medicaid eligibility.
Are my IRA and 401(k) counted for Medicaid in New York?
Not if they are in payout status, meaning you are receiving regular periodic distributions. The account balance is exempt, and the distributions are counted as income. As of 2026, the county may no longer require you to take the maximum periodic payment available. For many Westchester applicants this rule keeps the largest asset they own from being counted, without any transfer.
We already gave money to our children. Is it too late to plan?
No. Gifts made more than 60 months before a nursing home application are outside the look-back entirely, and gifts within the look-back create a calculable penalty period, not permanent disqualification. For home care, there is currently no look-back at all. Depending on the facts, gift and promissory note planning may reduce the impact of the penalty.
Can a Westchester resident apply under Connecticut or New Jersey rules instead?
No. Medicaid is administered by the state of residence. A Westchester resident applies under New York’s rules even if family members live in Connecticut or New Jersey or the applicant owns property there. We help New York clients coordinate an estate plan with property and family interests in other states. When another state’s law or local work is involved, we identify the additional legal assistance needed.
How long does a Westchester County Medicaid application take?
Processing time depends on the completeness of the application and the Institutional Assistance Unit’s workload. A well-documented nursing home application with prompt responses to county requests is often decided within a few months, and coverage can be granted retroactively for up to three months before the month of application if the applicant was eligible during that period. Incomplete applications are denied and must be refiled.
Will Westchester County take my house after I die?
New York recovers Medicaid benefits only from the probate estate of a recipient who received benefits at age 55 or older, and only after a surviving spouse or a minor, blind, or disabled child has died. A home held in a properly drafted trust, owned jointly with right of survivorship, or passing under a retained life estate is generally outside the probate estate and not subject to recovery. A home held in the recipient’s sole name is exposed.
