Medicaid Spend-Down
New York — Home & Asset Rules 2026
New York Medicaid requires applicants to spend down assets to qualify for nursing home or long-term care coverage. In 2026, a single applicant must have countable assets under $33,038. The family home is often the largest asset — and understanding whether it counts, when it must be sold, and what the 60-month lookback period means is essential before making any financial moves.
NCB is not a law firm. This page is general educational information. Laws change. Consult a licensed New York elder law attorney. Bar Association of Erie County: (716) 852-8687 · OMIG: omig.ny.gov
Asset Limits 2026
To qualify for New York Medicaid long-term care (nursing home or HCBS waiver), an applicant must reduce countable assets to the limit. These figures are effective January 1, 2026, published by the NY State Department of Health.
| Category | 2026 Limit |
|---|---|
| Single applicant — countable assets | $33,038 |
| Married couple (both applying) | $44,796 |
| Community Spouse Resource Allowance (max) | $162,660 |
| Community Spouse Resource Allowance (min) | $74,820 |
| Home equity limit (nursing home Medicaid) | $1,130,000 |
| Monthly income limit (nursing home single) | $1,836/month |
| Personal Needs Allowance (what recipient keeps) | $50/month |
| Community Spouse Monthly Income Allowance | $4,066.50/month |
Counts Against the Limit
The family home is frequently the largest asset a WNY family owns — but it is not automatically a countable asset for Medicaid purposes. Whether it counts depends entirely on who is living in it.
| Situation | Home Status |
|---|---|
| Applicant lives in the home (or intends to return) | Exempt — up to $1,130,000 equity |
| Applicant’s spouse lives in the home | Exempt — regardless of equity amount |
| Child under 21 lives in the home | Exempt — regardless of equity |
| Blind or disabled child (any age) lives in home | Exempt — regardless of equity |
| Home is vacant, no qualifying family member | Countable if equity exceeds limit — may need to be sold |
A home being exempt from the asset limit does not mean it is protected from Medicaid estate recovery (MERP) after death. New York MERP can still file a claim against the home through the probate estate — even if the home was exempt during the Medicaid application. These are two separate issues. See our Medicaid Lien on Home guide.
If a home sale is part of the spend-down plan, NCB can give you a real cash number — something your elder law attorney can actually work with. We work with DSS timelines and close when it makes sense. No pressure. Call (716) 557-7005.
What It Means for Your Home
New York Medicaid for nursing home care includes a 60-month (5-year) lookback period. Any asset transferred below fair market value within those 60 months triggers a penalty period of Medicaid ineligibility.
Transferring ownership of the home — by gift, quitclaim deed, or below-market sale — within 60 months of applying for Medicaid nursing home benefits. The penalty is calculated by dividing the transfer value by the average monthly nursing home cost in New York (~$15,000/month in 2026).
If a parent gifts a $150,000 home to their child 2 years before applying for Medicaid nursing home coverage: $150,000 ÷ $15,000/month = 10 months of Medicaid ineligibility. During that period, care costs must be paid privately.
Selling the home at fair market value — including to NCB at a cash price — is not a disqualifying transfer. The home converts to cash (a countable asset), which then becomes part of the spend-down. This is a normal and accepted part of Medicaid planning.
What assets must be spent down for Medicaid in New York?
Countable assets include bank accounts, stocks, bonds, CDs, second properties, and most cash equivalents. The primary home is typically exempt while the applicant or certain family members live there. Non-countable assets include one vehicle, personal property, irrevocable funeral trusts, and life insurance with face value under $1,500. In 2026, a single nursing home Medicaid applicant must reduce countable assets to $33,038. DISCLAIMER: Asset rules are complex. Consult a licensed NY elder law attorney for your specific situation.
Can I sell my home to pay for nursing home care and still qualify for Medicaid?
Yes. Selling the home at fair market value is not a disqualifying transfer for Medicaid purposes. The sale proceeds become countable assets, which are then spent down on care costs until the asset limit is reached ($33,038 for a single applicant in 2026). A properly structured home sale is a normal and accepted component of Medicaid spend-down planning. DISCLAIMER: Consult a licensed NY elder law attorney before any asset transfer or Medicaid application.
Does the 60-month lookback apply to selling a home?
Selling at fair market value does not trigger a Medicaid penalty — only transfers below fair market value (gifts, quitclaim deeds, below-market sales) trigger the lookback. If you sell your home to a cash buyer at a fair market price, the proceeds are treated as countable assets, not penalized transfers. DISCLAIMER: What constitutes “fair market value” can be disputed. Consult a licensed NY elder law attorney before any transaction.
Areas We Serve
NCB purchases homes across all of Buffalo and Western New York — any condition, any situation, all contents included.
How does Medicaid spend-down work in New York? 2026 asset limits, what counts, home equity rules, the 60-month lookback, and how a home sale fits into Medicaid planning. Nickel City Buyers, LLC · 3842 Harlem Rd STE 400-339, Cheektowaga, NY 14215 · (716) 557-7005. Not legal or Medicaid advice. A+ BBB · 300+ homes since 2013.
Want to Know What
the Home Would Net?
The spend-down plan only works if you know the number. NCB can give you a real cash offer — no obligation — so you and your elder law attorney have an accurate figure to work with.