PROPOSED LEGISLATION: New York LTC Trust Act
New York Long-Term Care Trust Act:
Why Residents May Want Private LTC Insurance Before the Deadline
New York is considering a Long-Term Care Trust Act that could create a state-run long-term care benefit funded by mandatory payroll contributions. If enacted, the law may allow residents to opt out only if they already have qualifying private long-term care insurance in place before the required deadline.
The key planning concern: your private LTC insurance policy may need to be active before January 1 of the year the law takes effect.
Independent long-term care insurance specialists with nationwide experience, educational resources, and step-by-step guidance.
Possible Deadline to Purchase Long Term Care Insurance in New York State
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What is Long Term Care?
There are many different services that would fall under the definition of long-term care. These services include institutional care in nursing facilities or non-institutional care such as home health care, personal care, adult day care, long-term home health care, respite care and hospice care.
- Nursing homes in New York State are licensed under the Public Health Law.
- Home health care consists of services received in your home, and can include skilled nursing care, speech, physical or occupational therapy, or home health aide services.
- Home care (personal care) consists of assistance with personal hygiene, dressing or feeding, nutritional or support functions, and health-related tasks.
- Adult daycare can provide supervision and other social, recreational, and in some cases, health services during the day, in a group setting outside the home, for elderly persons who still live at home.
- Assisted living facilities provide housing and ongoing care and services to those unable to perform activities of daily living or who have a cognitive impairment.
- An alternate level of care is care received as a hospital inpatient when there is no medical necessity for being in the hospital and is for those persons waiting to be placed in a nursing home or while arrangements are being made for home care.
- Respite care is temporary institutional or at-home care of a dependent elderly, ill, or handicapped person, providing relief for their usual caregivers.
- Hospice care is a program of care and treatment, either in a hospice care facility or in the home, for persons who are terminally ill and have a life expectancy of six months or less.
Will I Need Long-Term Care?
The chances of needing some type of long-term care services is high. It is estimated that over 40% of all persons who were 65 years old in 1990 will enter a nursing home during their lifetimes.
The Cost of Long-Term Care in New York
Long-term care is very expensive. Most people cannot afford to privately pay for long-term care services for very long.
Nursing home care costs vary in New York from $455 per day in Central New York to $536 per day in the Rochester area, which is approximately $166,075 per year in Central New York to $195,538 per year in the Rochester area.
Downstate, nursing home costs vary from $547 per day in the Metropolitan area to $475 per day in Long Island, which is approximately $199,589 per year in the Northern Metropolitan area to $173,375 per year in Long Island. It is estimated that people in nursing homes stay on average for less than 2½ years.
Home health care is also expensive. According to an industry survey, the average cost of home health care in New York State in 2025 was $35 per hour. Assuming 20 hours of care per week, average home health care costs throughout the State reach $36,400 per year.
Source: CareScout
Is Long-Term Care Covered By Medicare or Health Insurance?
Medicare: Medicare does NOT pay for most long-term care services. Individuals should not rely on Medicare to meet their long-term care service needs. Medicare does not pay for custodial care when that is the only kind of care needed. Skilled nursing facility care is covered by Medicare but only on a very limited basis.
If you need skilled health care in your home for the treatment of an illness or injury, Medicare may pay for some part-time or intermittent home health services furnished by a home health agency. Visit www.medicare.gov and www.cms.gov for more information on what is/is not covered by Medicare.
Medicare Supplement Insurance Plans: These plans are designed to fill in some of the gaps in Medicare coverage, but they do NOT cover most long-term care services.
Private health insurance: that you might already have covers mainly acute conditions and probably does NOT cover long-term care.
Medicaid: In order to qualify for Medicaid coverage, you must meet certain income and asset tests. Because of the high cost of nursing home care, more than half of those who enter nursing homes privately paying for their care deplete their assets to the level required to qualify for Medicaid in less than a year.
- Single Applicant: $33,038
- Married Couple (Both Applying): $44,796
- Married Couple (One Applying – Nursing Home): The applying spouse can keep $33,038. The non-applying spouse can keep between $74,820 and $162,660 (the Community Spouse Resource Allowance, or CSRA).
- Home Equity Limit: Up to $1,130,000 in equity in a primary residence is exempt.
For further assistance, please contact
Scott A. Olson at 877-727-9582
or email Scott at Scott@LTCShop.com
New York License #: LA-986644