If you're lying awake at night wondering how you'll protect your hard-earned savings from medical bills, you're not alone. I've sat across from countless families in Brooklyn who share the same worry—watching their lifetime of work potentially disappear to pay for long-term care or unexpected medical expenses. It's a fear that keeps middle-income families up at night, and honestly, it's one of the most valid concerns you can have about your financial future.
Let me share something that might surprise you: you don't have to choose between getting the care you need and protecting what you've worked so hard to build. With the right planning and strategies, you can safeguard your assets while ensuring you and your loved ones receive quality care when it matters most.
Understanding Why This Worry Is So Real
The statistics are sobering. A single year in a New York nursing home can cost upwards of $150,000—sometimes even more in areas like Brooklyn, Queens, and Staten Island. If you need home care assistance, you're looking at costs that can easily reach $30,000 to $50,000 annually, depending on the level of care required. These aren't just numbers on a page; they represent your family home, your retirement savings, and the inheritance you hoped to leave for your children and grandchildren.
I remember Maria, a Brooklyn grandmother who came to see me after her husband suffered a stroke. "We saved for forty years," she told me, tears in her eyes. "Is it all going to disappear?" Her story isn't unique. For middle-class families who don't qualify for immediate Medicaid assistance but don't have millions in the bank, the path forward can feel impossible to navigate.
The good news? There are legitimate, legal strategies to protect your assets. The key is understanding them and, most importantly, acting before a crisis hits.
The Power of Early Planning: Why Tomorrow Might Be Too Late
Here's something critical you need to know: Medicaid has what's called a "look-back period." In New York, this means that when you apply for nursing home coverage through Medicaid, the state will examine every financial transaction you made in the previous five years. If they find that you transferred assets for less than fair market value—like gifting your house to your children or moving money to relatives—you could face a penalty period where you're ineligible for benefits.
Think of it this way: if you wait until you're already sick or in crisis, your options become extremely limited. But if you plan ahead—ideally several years before you might need care—you open up a world of protective strategies.
This is why I always tell families: the best time to start protecting your assets was five years ago. The second-best time is right now.
Strategy #1: Medicaid Asset Protection Trusts
One of the most powerful tools for asset protection is something called a Medicaid Asset Protection Trust, or MAPT. This is an irrevocable trust—meaning once you create it and transfer assets into it, you can't simply change your mind and take everything back out.
I know what you're thinking: "Why would I give up control of my assets?" It's a fair question, and it requires a leap of faith. But here's how it works and why it can be so effective.
When you place assets—like your home, savings, or investments—into a MAPT, those assets are no longer legally considered yours for Medicaid purposes. After the five-year look-back period passes, these assets are completely protected from being counted when determining your Medicaid eligibility. This means you can qualify for long-term care benefits without having to "spend down" everything you've saved.
The beauty of a MAPT is that while you give up ownership, you can still structure the trust to receive income from those assets during your lifetime. You can continue living in your home if that's what's placed in the trust. You're essentially creating a protective shield around your wealth while still maintaining many of the practical benefits.
At Alatsas Law Firm, we help families in Brooklyn, Queens, and Staten Island set up these trusts in ways that make sense for their unique situations. We understand the cultural importance of passing down family homes and ensuring your children aren't burdened with impossible choices.
Strategy #2: Understanding What's Already Protected
Before you start restructuring your entire financial life, you should know that certain assets are already exempt from Medicaid calculations. These include:
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Your primary residence (with some conditions and equity limits)
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One vehicle
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Personal belongings and household items
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Prepaid funeral and burial arrangements
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A small amount of cash (typically around $31,175 in New York for 2025)
Knowing what's protected helps you focus your planning efforts on the assets that are actually at risk. Your family home, for instance, is generally safe while you're living, though Medicaid may seek reimbursement from your estate after you pass away—something we can also plan around.
Strategy #3: Long-Term Care Insurance
For some families, long-term care insurance can be a game-changer. The catch? You need to purchase it while you're still relatively young and healthy—typically in your 50s or early 60s. Wait too long, and the premiums become unaffordable, or you may not qualify due to pre-existing health conditions.
A good long-term care policy can cover nursing home expenses, assisted living, and even home health care. This means your savings remain untouched because the insurance company picks up the tab. Think of it as protecting your assets by transferring the risk to an insurance company.
The trade-off is that you'll pay monthly or annual premiums for years—maybe decades—before you need the coverage. But for many families, that peace of mind and asset protection is worth the investment.
Strategy #4: Strategic Gifting and Exempt Transfers
You might be wondering, "Can't I just give my money to my kids?" In theory, yes—but remember that five-year look-back period. Any gifts you make within five years of applying for Medicaid can trigger penalties.
However, there are some exceptions and strategic approaches. For instance:
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You can make small annual gifts that fall under the IRS gift tax exclusion (currently $18,000 per person as of 2025)
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Payments made directly to medical providers or educational institutions for someone else's benefit aren't considered gifts
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Transfers to a disabled child or into certain types of special needs trusts may be exempt
The key is documentation and timing. If you're thinking about gifting assets to family members, you need to do it properly and well in advance of when you might need Medicaid assistance.
Strategy #5: Life Estate Deeds
A life estate deed is another tool that can protect your home. With this approach, you transfer ownership of your house to your children (or other beneficiaries) while retaining the right to live in the home for the rest of your life.
The advantage? After the five-year look-back period, your home is no longer counted as your asset for Medicaid purposes. You still get to live there, maintain it, and benefit from it—but legally, it's not yours anymore, so it's protected.
The downside is that you've given up some control. If you later want to sell the house or take out a mortgage, you'll need the cooperation of the people you transferred it to. This is why it's crucial to have open, honest conversations with family members and work with an attorney who understands family dynamics.
Real Stories: How Planning Made All the Difference
Let me tell you about George and Helen, a couple from Staten Island who came to see me about eight years ago. George had watched his own father lose everything to nursing home costs, and he was determined not to let that happen to his family.
We created a comprehensive plan that included a Medicaid Asset Protection Trust for their home and most of their savings. They kept enough liquid assets for their daily needs and emergencies. Five years later, when Helen needed assisted living care, their assets were protected. She qualified for Medicaid assistance, their home remained in the trust for their children, and George didn't have to choose between his wife's care and their financial security.
"I only wish we'd done this sooner," George told me. "The peace of mind alone was worth it."
What Happens If You're Already Facing a Health Crisis?
If you're reading this and thinking, "It's too late for me—I'm already sick," don't despair. While your options may be more limited, there are still strategies we can explore.
Sometimes we can use something called a Medicaid-compliant annuity, which converts a lump sum of assets into a stream of income. There are also strategies involving spousal protections that can preserve assets for a healthy spouse when one partner needs care.
Even in crisis situations, having an experienced elder law attorney review your situation can make a significant difference in what you're able to protect.
The Cultural Dimension: Why This Matters Especially for Brooklyn Families
In the diverse communities of Brooklyn, Queens, and Staten Island, family isn't just important—it's everything. The idea of your children having to choose between caring for you and protecting their own futures, or watching the family home you worked so hard for be sold off—these aren't just financial concerns. They're deeply personal, emotional, and cultural.
Many of our clients come from backgrounds where the family home represents generations of struggle and achievement. Losing it to medical costs feels like losing part of your family's identity and history. That's why at Alatsas Law Firm, we approach asset protection not just as a legal exercise but as a way to honor your life's work and preserve your legacy.
Taking the First Step: What You Should Do Today
If you're worried about losing your savings to medical expenses, here's what I recommend you do right now:
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Take inventory: Make a list of all your assets—your home, savings accounts, investments, retirement accounts, vehicles, and any other valuable property.
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Estimate potential care costs: Research what long-term care costs in your area. This helps you understand the scope of what you're protecting against.
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Review your current estate planning documents: Do you have a will? Powers of attorney? Are they up to date? These basic documents are essential before tackling more complex planning.
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Schedule a consultation with an elder law attorney: Look for someone who specializes in asset protection and Medicaid planning in your state. Laws vary significantly, and you need expertise specific to New York.
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Have family conversations: Asset protection planning affects your whole family. Talk openly with your children or other heirs about your concerns and wishes.
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Don't wait: Remember, the five-year look-back period means that planning done today won't provide full protection until five years from now. Every day you delay is a day lost.
Common Mistakes to Avoid
In my nearly 30 years of practice, I've seen some common mistakes that can derail even the best intentions:
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Transferring assets without legal guidance: Just handing over your house to your kids might seem simple, but it can create tax problems, leave you vulnerable, and still trigger Medicaid penalties if not done correctly.
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Waiting until crisis hits: By the time someone is in the hospital or already needing care, many protective strategies are off the table.
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Not considering all family members: Sometimes families protect assets for one generation while inadvertently creating problems for the next.
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Choosing the wrong trustee: If you create a trust, picking the right person to manage it is crucial. This needs to be someone responsible, trustworthy, and capable of handling financial matters.
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Failing to update plans: Life changes—people move, laws change, financial situations evolve. Your asset protection plan should be reviewed periodically.
The Bottom Line: You Have More Control Than You Think
The fear of losing everything you've worked for to medical expenses is real and justified. But you're not powerless. With proper planning, legal expertise, and action taken soon enough, you can protect your assets while ensuring you receive the care you need.
The strategies we've discussed—Medicaid Asset Protection Trusts, long-term care insurance, strategic gifting, life estate deeds—these aren't tricks or loopholes. They're legitimate legal tools designed to help families like yours navigate the overwhelming costs of aging and healthcare in America.
At Alatsas Law Firm, we've spent years helping middle-income families in Brooklyn, Queens, and Staten Island face these challenges. We understand the sleepless nights, the worry about your children's inheritance, the fear of becoming a burden. But we've also seen countless families find peace of mind through careful planning and the right legal protections.
Your savings represent decades of hard work, sacrifice, and dreams for your family's future. They deserve protection, and so do you. The question isn't whether you can afford to plan—it's whether you can afford not to.
What step will you take today to protect what you've spent a lifetime building?
