What is the Medicaid Eligibility in New York?

What is the Medicaid Eligibility in New York?Medicaid is the government program that assists low income patients with their medical expenses and provides them with healthcare that would otherwise be unaffordable. Services such as doctor visits, hospital stays, prescriptions, supplies, home health care, nursing home care, and more are covered for beneficiaries of the program. In New York, patients must meet certain criteria set by the New York State Department of Health to be eligible for Medicaid.

Eligibility Rules

Eligibility rules for Medicaid are extremely complicated and consider the applicant’s age, living situation, health, and family status. Requirements are different depending on whether a person is married or single, has children, or is disabled.

Seniors applying for Medicaid to cover long-term care in the state of New York must be:

  • A U.S. citizen and a New York state resident
  • Aged 65 or older
  • In need of the level of care found in nursing facilities

Additionally, certain financial requirements must be met regarding the applicant’s monthly income and assets.

Income and Asset Requirements

Individuals applying for Medicaid to cover long-term care may have resources totaling $15,150 and couples who both need long-term care may have a total of $22,200. Resources include:

  • Cash
  • Savings
  • IRA accounts
  • 401k accounts
  • Stock accounts
  • Bonds
  • Life insurance
  • Property

One car per household may be excluded from the resource limit, regardless of its value. If it is medically necessary for the household to have two cars, then a second car may be excluded from the resource limit. If only one spouse needs long-term care, then the other person, known as the community spouse, can keep half of their assets up to $123,600 and their entire marital assets up to $74,820.

An important exemption from the allowance for assets is the applicant’s homestead if it is essential and appropriate to the needs of the household. Equity in the house is allowable up to $858,000.

Excess Income

Anything above the resource limit amount is considered excess income. For applicants with resources above the limits, there are strategies that can be employed to meet the eligibility criteria, such as the Medicaid Excess Income program. Another strategy is to use a trust to hold assets and pay necessities, such as rent, so that the amount of resources remains under the limit. If the equity in the home is greater than the allowable amount, reverse mortgages and home equity lines of credit are useful tools for reducing equity.

Long term planning is crucial for those hoping to qualify for Medicaid. In the five years prior to an individual’s Medicaid application, any financial gifts made will incur a penalty and delay eligibility for Medicaid benefits. Medicaid eligibility is complex and confusing, but experts in elder law have many different strategies for protecting income while helping their clients qualify for long-term care.

Brooklyn Elder Law Attorneys at Korsinsky & Klein, LLP Assist Clients with Medicaid Concerns

If you or a loved one has questions about eligibility for Medicaid, Medicaid planning, or Medicaid hearings, the experienced Brooklyn elder law attorneys at Korsinsky & Klein, LLP are ready to assist you. Call us at 212-495-8133 today to schedule a consultation or complete our online contact form. Located in Brooklyn, New York, and Lakewood, New Jersey, we proudly serve clients throughout Manhattan, Long Island, and Westchester, New York.