Exploring the Benefits of Assisted Living Facilities

Does Medicaid Pay for Assisted Living in New York?

In most cases, the answer is no. Traditional Medicaid does not typically cover the cost of assisted living facilities.

However, New York does offer a special program called the Assisted Living Program (ALP), which does provide Medicaid coverage for certain approved assisted living residences. There are a limited number of facilities that participate in this program, including several on Long Island.

The High Cost of Assisted Living

Most assisted living facilities accept only private pay or long-term care insurance. Monthly costs can easily reach $7,000 or more. For individuals who cannot afford these private rates, the ALP program may offer a more affordable alternative.

Medicaid Eligibility for the ALP Program

Eligibility for the Assisted Living Program follows the rules for community Medicaid.

One important advantage is that there is no “look-back” period. This means there are no penalties for past transfers of assets, gifts, or Medicaid planning strategies that may have been completed before applying.

Asset and Income Requirements

The asset limits for ALP are similar to standard community Medicaid rules. For example, a single individual cannot have more than $15,450 in countable assets (based on 2019 guidelines), with certain exceptions.

However, income rules are different. Under traditional community Medicaid, applicants are generally allowed to keep about $879 per month. Under the ALP program, the amount a recipient may keep depends on their level of care and is typically lower.

Using a Pooled Income Trust

Even with lower income limits, ALP recipients may still use a pooled income trust to manage excess income.

A pooled trust allows individuals to shelter income above Medicaid limits, so it does not have to be spent entirely on care. This can help recipients maintain a better quality of life and cover personal expenses.

A Valuable Alternative to Nursing Home Care

The Assisted Living Program can be an excellent option for individuals with limited financial resources who want to live in an assisted living setting.

Without this program, many people may be forced into nursing home care earlier than necessary simply because they cannot afford private assisted living costs.

ALP helps bridge that gap by providing supportive housing while preserving dignity, independence, and quality of life.

If you would like to speak with an experienced elder law attorney regarding your situation or have questions about something you have read, please do not hesitate to contact our office at 1 (800) 680-1717. We look forward to the opportunity to work with you.

Disclaimer: The information provided above is for general informational purposes only and is not legal advice.