What is the income limit to qualify for Medicaid in NY?
Starting 1 January 2023 the increased income and asset limits to be eligible for Medicaid in New York went into effect. Here are the new requirements.
The New York State Legislature and Governor Kathy Hochul reached an agreement in April as part of the Empire State’s budget to increase the income and asset limits to qualify for Medicaid. The changes apply to those who are 65 years or older, blind, or disabled and went into effect 1 January 2023.
There are three categories of Medicaid long-term care programs, Institutional Medicaid, Community Medicaid and Regular Medicaid. The financial eligibility criteria vary depending on marital status and those that exceed the limits may be able to use alternative ways to become eligible for coverage.
Who is eligible for Medicaid in New York?
Seniors in New York besides having limited income must be medically eligible for long-term care Medicaid, requiring the level of care provided in a nursing home facility for Institutional Medicaid and Community Medicaid. In the case of Regular Medicaid applicants (those 65 and older, blind and disabled) must need help with activities of daily living.
The allowable levels of income were raised to 138 percent of the Federal Poverty Level (FPL), or less than $1,677 per month for an individual, and $2,268 in the case of both spouses applying for all three categories. Likewise the maximum assets were increased by 50 percent to $30,180 for an individual applicant and $40,820 when both spouses are applying.
However, when just one spouse applies for Institutional Medicaid or Community Medicaid, the individual income limits apply but for Regular Medicaid the income and asset limits are higher, $2,268 and $40,820, respectively.
The state provides free assistance for those who wish to apply for Medicaid, Medicare and the Medicare Savings Program.
Qualifying for Medicaid when income exceeds limits
There are two accepted and common ways to qualify for Medicaid long-term care if your monthly income exceeds eligibility levels. You can join a pooled trust or spend down your excess income.
When you join a Pooled Income Trust you will deposit your excess income into a trust that will be used to pay for qualified monthly expenses. This will need to be done on a monthly basis and has to be reported to Medicaid for review.
The other option to meet the income and asset eligibility limits for Medicaid is to use a “spend down” of your excess income. This is available to those who have high medical bills, including deductibles and premiums as well as medical expenses such as doctor visits, medical supplies and prescription drugs.