This page provides a plain-English summary of key elder care and estate planning information specific to New York residents. It covers New York Medicaid limits, estate tax rules, advance directive information, and links to important New York agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
New York Medicaid — 2026 Eligibility Limits for Long Term Care
New York Medicaid has some of the most distinctive rules in the country including higher asset limits than most states, a unique Community Medicaid program with no look-back period, and the use of pooled income trusts. Understanding these rules is essential for New York families planning for long term care.
Nursing Home Medicaid — income limit The income limit for a single nursing home Medicaid applicant is $1,836 per month in 2026. Nursing home residents are allowed to keep only $50 per month as a personal needs allowance — the remainder of income goes toward the cost of care.
Nursing Home Medicaid — asset limit A single nursing home Medicaid applicant may retain up to $33,038 in countable assets in 2026. This is significantly higher than the $2,000 limit in most other states. The home is generally exempt if the applicant intends to return or if a spouse or qualifying dependent lives there, with a home equity limit of $1,130,000.
Community Medicaid — home and community based care New York’s Community Medicaid program funds home care and community based services for people who need nursing home level care but want to remain at home. The asset limit for Community Medicaid is also $33,038 for a single applicant in 2026. The income limit is $1,836 per month for a single applicant.
Critically important — no look-back for Community Medicaid Unlike nursing home Medicaid which has a 60-month look-back period Community Medicaid currently has no look-back period for asset transfers. This is one of New York’s most significant Medicaid planning advantages — assets can be transferred without triggering a penalty period for people seeking home care rather than nursing home care. However New York has announced plans to implement a 30-month look-back for Community Medicaid. As of early 2026 the implementation date has not been set. New Yorkers should consult with an elder law attorney promptly to take advantage of this planning window before the look-back takes effect.
Nursing home look-back period New York has a 60-month — five year — look-back period for nursing home Medicaid. Asset transfers made within 60 months of applying for nursing home Medicaid that were for less than fair market value may result in a penalty period of ineligibility.
Married couples — one spouse applying When only one spouse applies for Medicaid the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $74,820 the community spouse may retain 100 percent of assets up to $74,820.
Community Spouse Monthly Income Allowance The community spouse is entitled to a minimum monthly income allowance — called the Community Spouse Monthly Income Allowance or CSMIA in New York — of up to $4,066.50 per month in 2026.
Pooled income trusts New York allows Medicaid applicants whose income exceeds the limit to use pooled income trusts — trusts established and managed by nonprofit organizations — to shelter excess income and qualify for Medicaid. This is an important and widely used planning tool in New York particularly for Community Medicaid recipients.
How to apply for New York Medicaid Applications can be submitted online at nystateofhealth.ny.gov, by phone at 1-800-541-2831, or in person at your local county Department of Social Services.
New York Medicaid administering agency New York State Department of Health — health.ny.gov — and local county Departments of Social Services handle Medicaid eligibility determinations.
New York Estate Tax — 2026
New York imposes its own state estate tax with rules that differ significantly from federal law. New York residents with moderate to large estates need to plan carefully for the state estate tax in addition to any federal estate tax exposure.
New York estate tax exemption The New York estate tax exemption is $7,350,000 per person in 2026. Estates valued at or below this amount owe no New York estate tax.
The New York estate tax cliff — critical planning issue New York’s estate tax includes a dangerous cliff effect that can dramatically increase estate tax liability. If an estate exceeds the exemption amount by less than 5 percent — meaning a value between $7,350,001 and $7,717,500 — the estate pays tax only on the amount above the exemption at progressive rates of 3 to 16 percent. However if the estate exceeds the exemption by more than 5 percent — meaning a value above $7,717,500 — the estate loses the exemption entirely and is taxed on the full value of the entire estate. This cliff effect can result in an effective tax rate well above 100 percent on the amount just over the threshold. New York residents with estates approaching the exemption amount should work with an estate planning attorney to avoid triggering the cliff.
No portability The New York estate tax exemption is not portable between spouses. Unlike the federal system a surviving spouse cannot use their deceased spouse’s unused New York exemption. Married couples with combined estates above $7,350,000 should use trust planning to ensure both spouses’ exemptions are utilized.
No New York gift tax New York does not impose a state gift tax. However gifts made within three years of death are added back to the New York taxable estate. This three-year lookback for gifts is an important distinction from federal law and limits the effectiveness of last-minute gifting strategies.
Federal estate tax New York residents may also be subject to federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses and the top federal rate is 40 percent on amounts above the exemption. Many New York estates will owe state estate tax but not federal estate tax due to the large gap between the state and federal exemptions.
New York estate tax return The New York estate tax return — Form ET-706 — is filed with the New York State Department of Taxation and Finance. The return and any tax owed are due within nine months of the date of death.
New York Advance Directives
New York law recognizes the following advance directive documents:
New York Health Care Proxy Names a healthcare agent to make medical decisions on your behalf when you are unable to do so. Must be signed and witnessed by two adults. The agent cannot also serve as a witness. This is the primary healthcare decision making document in New York.
New York Living Will Documents your wishes regarding life-sustaining treatment. New York does not have a specific statutory living will form but living wills are recognized under New York common law and the Patient Self-Determination Act.
New York MOLST — Medical Orders for Life-Sustaining Treatment New York uses the MOLST form for seriously ill patients to document specific medical orders regarding CPR, artificial ventilation, and artificial nutrition. Must be signed by a physician or nurse practitioner. New York maintains a MOLST registry.
Do Not Resuscitate Order — DNR A physician order directing healthcare providers not to perform CPR. DNR orders in New York must be documented in the medical record.
Free New York advance directive forms Free New York-specific advance directive forms are available at caringinfo.org and from the New York State Department of Health at health.ny.gov.
New York Key Agencies and Resources
New York State Department of Health Oversees New York Medicaid policy and long term care programs. Website: health.ny.gov Phone: 1-800-541-2831
New York State Office for the Aging — NYSOFA Coordinates programs and services for older New Yorkers including the Expanded In-Home Services for the Elderly Program — EISEP — and caregiver support services. Website: aging.ny.gov Phone: 1-800-342-9871
New York Area Agencies on Aging New York is served by 59 county-based Area Agencies on Aging that coordinate local services for older adults and caregivers. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
New York Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes assisted living facilities and adult care facilities. Investigates complaints and helps resolve problems free of charge. Website: ltcombudsman.org/states/new-york Phone: 1-800-342-9871
New York State Department of Taxation and Finance — Estate Tax Administers the New York State estate tax. Website: tax.ny.gov Estate Tax Information: tax.ny.gov/pit/estate
New York State Bar Association Lawyer Referral Service Connects New Yorkers with attorneys including those who specialize in elder law and estate planning. Website: nysba.org Phone: 1-800-342-3661
New York Legal Assistance Group — NYLAG Provides free civil legal services to low income New Yorkers including seniors on issues related to Medicaid benefits and elder law. Website: nylag.org Phone: 1-212-613-5000
New York Veterans Resources
New York State Division of Veterans’ Services Provides services and benefits to New York veterans and their families including free VA claims assistance, veterans counseling, and benefits information. Website: veterans.ny.gov Phone: 1-888-838-7697
New York State Veterans Homes New York operates veterans homes providing long term care to eligible veterans and their spouses. Facilities are located in Oxford, Montrose, Saint Albans — Queens, Batavia, and Stony Brook. Website: veterans.ny.gov/veterans-homes
New York Senior Property Tax Benefits
Enhanced STAR — School Tax Relief Program New York homeowners aged 65 and older who meet income requirements may qualify for the Enhanced STAR exemption which provides a larger reduction in school district taxes than the Basic STAR program. The income limit for Enhanced STAR adjusts annually. Apply through your local assessor’s office.
Senior Citizens Homestead Exemption New York allows municipalities to grant a partial property tax exemption to seniors aged 65 and older who meet income requirements. The exemption reduces the assessed value of the home by up to 50 percent depending on income. Availability and income limits vary by municipality.
New York Circuit Breaker — Real Property Tax Credit New York residents aged 65 and older with income below the limit may qualify for a state income tax credit based on property taxes paid. Apply using Form IT-214 when filing your state income tax return.
Finding Elder Law and Estate Planning Attorneys in New York
The following resources can help you find a qualified elder law or estate planning attorney in New York:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- New York State Bar Association Lawyer Referral Service — nysba.org — 1-800-342-3661
- New York Chapter of NAELA — New York has an active NAELA chapter with members throughout the state
- New York Legal Assistance Group — NYLAG — nylag.org — free legal services for income-qualifying seniors
The information on this page is for general informational purposes only and does not constitute legal or financial advice. New York Medicaid rules are among the most complex in the country and are subject to change — particularly regarding Community Medicaid look-back rules. Medicaid eligibility limits, estate tax rules, and other figures change frequently. Always verify current information with the relevant agency or a licensed elder law attorney. Laws vary and individual circumstances differ significantly.
Last updated: March 2026