Medicaid Planning Attorney in Smithtown, NY

Protect Your Home, Your Savings, and Your Family — While Qualifying for the Long-Term Care Coverage You Need

Nursing home care on Long Island costs $150,000–$180,000 per year. Home health aides can run $80,000–$120,000 annually. For most families, these costs are unsustainable — and they arrive with very little warning.

Medicaid exists to help. But qualifying without losing everything you’ve worked for takes planning and knowledge of New York’s complex eligibility rules. At Fratello Law, we have helped Long Island families navigate Medicaid since 2012 — protecting assets, completing applications correctly, and getting benefits in place as quickly as possible.

Whether you’re planning years ahead or facing an immediate care crisis, we can help.

Facing an urgent situation? Call now:
Smithtown: (631) 406-5580

Schedule Your Free Medicaid Planning Consultation →

How Medicaid Works for Long-Term Care in New York

New York Medicaid covers the cost of long-term care for people who meet financial eligibility requirements. There are two primary programs families need to understand:

Community Medicaid (Home Care & Assisted Living)

Community Medicaid covers care provided at home or in an approved assisted living facility. If your loved one needs help with daily activities — bathing, dressing, medication management, mobility — but does not yet need a nursing home, Community Medicaid can pay for home health aides, personal care aides, and certain assisted living costs. To qualify, income and resources must be within Medicaid limits. Excess income can often be addressed through a pooled income trust.

Nursing Home Medicaid (Chronic Care Medicaid)

Nursing Home Medicaid covers the full cost of a skilled nursing facility once a person is financially and medically eligible. Financial eligibility is strict: applicants may keep very limited resources (generally $31,175 in 2025 for a single person) and must assign most income toward their nursing home bill. A critical rule: New York applies a 60-month (5-year) look-back period for Nursing Home Medicaid. Any assets transferred within that window without fair market value consideration can trigger a penalty period — delaying coverage by months or years. This is why advance planning matters. But even in a crisis, options exist.

The Biggest Medicaid Myths — and the Truth

Many families delay planning — or give up entirely — because of misconceptions they’ve heard. Here are the most common ones we address every week:

Myth: “We have to spend down everything before qualifying.”
Truth: With proper planning, many assets can be legally protected. Certain assets are exempt from the Medicaid calculation — including the primary home in many situations. And legal strategies like irrevocable trusts, caregiver child transfers, and spousal protections can preserve significant assets.

Myth: “It’s too late to do anything now that Mom is in the nursing home.”
Truth: Even after a nursing home admission, meaningful planning may still be possible. Spousal protections, certain exempt transfers, and half-a-loaf planning strategies can protect assets even in crisis situations. Time matters — call us immediately.

Myth: “If we give assets to the children, they’ll be protected.”
Truth: Gifts made within the 5-year look-back window can trigger Medicaid penalty periods. Transfers must be done correctly and at the right time. Unplanned gifting can cause more harm than good.

Myth: “We’ll lose the house to Medicaid.”
Truth: The home is generally exempt during the Medicaid recipient’s lifetime when a spouse or certain other individuals live there. Proper planning can also protect it from estate recovery after death. Don’t assume the worst — call us first.

Planning Ahead: The Most Powerful Time to Act

The ideal time to do Medicaid planning is 5 or more years before you need long-term care. When you plan ahead:

Assets transferred to an irrevocable trust age out of the look-back period
You have time to explore all strategies without the pressure of an immediate care need
Your home and savings can be protected while you remain fully in control of your life
A well-structured plan can coordinate with your overall estate plan, power of attorney, and healthcare documents

Irrevocable Medicaid Asset Protection Trusts

One of the most effective tools for advance Medicaid planning is an Irrevocable Medicaid Asset Protection Trust. Assets transferred into this trust are removed from your countable resources for Medicaid purposes — but you retain the right to income generated by those assets, and you can continue living in your home if it is transferred to the trust.

The trust must be in place for at least 5 years before a nursing home Medicaid application. That’s why the time to act is now, not when a health crisis forces your hand.

A family in Commack came to us when both spouses were in their early 70s and in good health. We helped them transfer their home and investment accounts into a Medicaid Asset Protection Trust. Six years later, when the husband needed nursing home care, the trust assets were fully protected — saving the family over $400,000.

Gifting Strategies

Certain asset transfers — to children, trusts, or other beneficiaries — may be part of a Medicaid plan, but they must be structured carefully and with awareness of the look-back period. Done incorrectly, premature gifting can disqualify a loved one from Medicaid at the worst possible moment.

We review your complete financial picture before recommending any transfer strategy.

Need Medicaid Now? We Handle Crisis Planning Too

Life does not always allow for five-year plans. A sudden stroke, a fall, a rapid cognitive decline — these events force families to act immediately. We work with families in crisis every week, and there is almost always something we can do.

Even when a loved one has already entered a nursing home, the following strategies may be available:

Spousal protections: The healthy spouse (community spouse) may keep the house, a car, and a protected amount of savings — up to the Community Spouse Resource Allowance (CSRA). We ensure the healthy spouse is fully protected and does not face unnecessary impoverishment.
Half-a-loaf planning: In some situations, a structured combination of gifting and annuitizing can protect a portion of assets even within the look-back period.
Exempt asset conversions: Certain asset conversions — prepaying funeral expenses, purchasing a new vehicle, paying off a mortgage — are allowable and can reduce countable resources.
Income-only trusts and pooled trusts: These tools address excess income that would otherwise disqualify an applicant.
Caregiver child exception: A child who lived with and cared for a parent for two or more years before nursing home admission may be able to receive a transfer of the home without triggering a penalty.

If you are in a crisis right now, call us today. Every day matters.

Smithtown: (631) 406-5580

Our Medicaid Planning Services

Fratello Law handles all aspects of Medicaid planning and application for Long Island families. Here’s what we do:

Medicaid Nursing Home Application

Applying for Nursing Home Medicaid is one of the most document-intensive legal processes families face. A single missing form or incorrectly documented asset transfer can result in denial or a prolonged penalty period. We manage the entire application — gathering documents, addressing look-back period issues, responding to agency requests, and following up until benefits are approved.

We serve families at nursing facilities throughout Suffolk County, including those in Smithtown, Hauppauge, Commack, Kings Park, St. James, Stony Brook, Nesconset, Centereach, and surrounding communities.

Medicaid Home Care Application (Community Medicaid)

If your loved one needs help at home, Community Medicaid can fund home health aides and personal care services. We help you understand eligibility, address asset and income issues, and complete the application correctly so home care services are in place without unnecessary delay.

Medicaid Assisted Living Program (ALP)

The Medicaid Assisted Living Program covers the care component of living in an approved assisted living residence. Qualifying for ALP requires navigating both Medicaid rules and the specific requirements of the facility. We help families understand eligibility and guide the application from start to finish.

CDPAP — Consumer Directed Personal Assistance Program

Through CDPAP, a family member or close friend can be paid by Medicaid to serve as a home caregiver. For many families, this is a meaningful alternative to hiring a stranger — and it keeps a loved one more comfortable at home. We guide you through the full CDPAP enrollment process.

Pooled Income Trusts

When a person’s monthly income exceeds the Medicaid income limit, a pooled income trust can bridge the gap. Income deposited into the trust is not counted against Medicaid eligibility, and funds in the trust can be used for supplemental needs — rent, utilities, food, personal expenses — that Medicaid does not cover.

Fratello Law works with approved pooled trust organizations and handles the enrollment paperwork on your behalf.

Medicaid Asset Protection Planning (Advance Planning)

For individuals and families who want to plan before a crisis, we offer comprehensive Medicaid asset protection planning — including irrevocable trusts, gifting strategies, and integration with your full estate plan. This is the most effective way to protect assets long-term.

Medicaid Applications and Appeals

If a Medicaid application has been denied or a penalty period assessed, we can often challenge the determination. New York law provides the right to a fair hearing before an Administrative Law Judge. We represent clients in Medicaid fair hearings and assist with appeals of incorrectly calculated penalties.

Protecting the Healthy Spouse

When one spouse needs nursing home care, the fear of impoverishment is real. New York’s spousal protection rules — governed by the federal Medicaid spousal impoverishment statutes — are designed to prevent this. But you need to know what you’re entitled to and fight for it.

Under current rules, the community spouse (the healthy spouse remaining at home) may generally keep:

The primary residence
One vehicle
A Community Spouse Resource Allowance (CSRA) — up to approximately $154,140 (2025 figure) in countable assets
A Minimum Monthly Maintenance Needs Allowance (MMMNA) — a portion of the institutionalized spouse’s income to meet the community spouse’s living expenses

These protections are important — but they are not automatic. Medicaid agencies do not always apply them correctly. Fratello Law ensures you receive every protection you are entitled to under the law.

Why Families Throughout Long Island Trust Fratello Law

Medicaid planning is one of the most consequential legal decisions a family makes. The stakes are high — often hundreds of thousands of dollars, a family home, and a loved one’s quality of care. Here’s what sets us apart:

We focus on elder law. Medicaid planning, asset protection, and elder law are at the center of what we do. Our attorneys stay current with New York’s frequently changing Medicaid rules and regulations — and bring that knowledge to every client.

We have been through it ourselves. Attorney Cheryl Fratello and our team have personally experienced the challenges of caring for aging loved ones. We understand the emotional weight of these decisions, and we approach every client with genuine empathy.

We treat clients like family. We are not a high-volume processing firm. We take time to understand your specific situation, explain your options clearly, and build a plan that works for you — not a generic template.

We are available when you need us. Long-term care crises do not wait for business hours. We make ourselves accessible to families facing urgent situations.

We are conveniently located in Smithtown. Our office at 26 Landing Avenue serves families throughout Suffolk County — Smithtown, Hauppauge, Commack, Nesconset, Kings Park, St. James, Stony Brook, Huntington, Centereach, Lake Grove, Port Jefferson, and surrounding communities.