Diving into Medicaid planning!

In my 20 years, I've seen the same mistakes constantly so I'm putting this together for anyone navigating this for the first time.

The biggest myth: "Mom has to spend down everything before Medicaid kicks in."

Not exactly. New York has specific rules about what counts as an asset, what can be protected, and how to plan legally so a spouse or family isn't left with nothing. Done right, Medicaid planning can protect a significant portion of a family's assets. Done wrong or too late, it can't.

The 5 year lookback is real and it matters.

Medicaid looks back 5 years at any asset transfers. Gifts to kids, adding someone to a deed, moving money around. If it looks like you were trying to qualify for Medicaid, there's a penalty period. Families who do this without legal guidance often create problems they don't discover until mom is already in a nursing home and the bills are due.

Community Medicaid vs. nursing home Medicaid are completely different programs.

Community Medicaid covers home care and has different rules and timelines than institutional Medicaid. New York recently changed the lookback rules for Community Medicaid so if you got advice more than a year ago, get it updated.

When to call an elder law attorney:

Honestly, before you think you need one. The best planning happens before a crisis, not during one. If your parent is healthy but aging, that's the time. If they just got a diagnosis, that's still okay. If they're already in a facility and you haven't planned, call tomorrow.

Happy to answer general questions in the comments. Just know that nothing here is legal advice for your specific situation, that requires an actual consultation.