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Important Changes to Community Medicaid


New York state has included a major change to medicaid in the 2020 budget...

Amid the worldwide pandemic, new york state has included a major change to medicaid in the state's 2020 budget.

This change relates to Community Medicaid (Medicaid for in-home care). Currently, there is no “lookback” to qualify for community-based Medicaid in New York State. This means that you can essentially transfer your assets and quality for Medicaid the following month.
This is going to change! The Medicaid modification is slated to take effect this October, though final details implementation are still pending. This change will create a 30-month (2.5 year) lookback for all Community Medicaid applications.
A lookback means any money gifted or transferred from the applicant to a family member or trust will result in a penalty period for non-coverage. That penalty period is based on the amount gifted. The final guidelines are not yet available.
It is anticipated (although not confirmed) that applications filed prior to October will be “grandfathered in” based on the old rules.
In the coming months, new strategies are expected to emerge to help people continue to protect some of their assets. However, this is a game changer that’s going to have a huge impact on the ability to protect your assets for in-home care services. My best advice to families anticipating long term care needs for aging loved ones is to consider moving towards a Medicaid filing sooner rather than later.
If you are not considering filing prior to this October, you should begin a discussion about how to care for your aging loved ones going forward, as this change will be financially devastating for many people.

In addition to the changes in the community lookback period, there will also be changes in the determination of how much care is needed in the home.

There is some good news, though. The options for Spousal Refusal will remain in place. This means spouses can still protect their assets when applying for Community Medicaid.

Strategy and planning are more critical than ever before.

Colin will be offering FREE weekly seminars on Community Medicaid and Nursing Home Medicaid via Zoom. Please check for information and registraton.

Colin Sandler, LCSW, CCM, is the owner of Medicaid Solutuions and has been providing advice on aging to seniors and their families for over 20 years. Call 914-924-2566 or email [email protected]; 2127 Comprond Rd, Cortlandt Manor, NY.
To find more articles by Colin on this topic, go to and enter “medicaid” into the search box on the right hand side of the page.

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