Medicaid Eligibility

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Medicaid Eligibility

New York State Medicaid should not be confused with the "Medicare Program". Unlike Medicare, which is availiable to nearly anyone 65 years or older, Medicaid is a combination of federal, state and local money which is administered by the state. Each state has there own Medicaid program, with its own set of rules and regulations. Medicaid serves poor people of all ages, particularly older people. In addition, older people who are not poor but have extensive health costs for a long period of time may use up (or transfer away) their assests to a point where they will eventually qualify for Medicaid eligibility.

The New York State Medicaid program is complicated and has many rules and regulations. Listed below is some basic eligibility information.

Please note: There is no cost of living increase for 2010 - therefore all Medicaid eligibilty figures remain the same as 2009.

2010 Medicaid Income Limit For Home Care

Single Person: $767 (+$20 exemption)

Couple: $1,117 ($20 exemption)

*Individuals who exceed these limits may be eligible under the Surplus Income Program. Surplus income (over $767) is contributed to the cost of care, unless a 'Pooled Income Trust" is established.

2010 Medicaid Income Limit For Nursing Home

$50 per month. All surplus income must be given to the nursing home, unless there is a well spouse living in the community.

2010 Medicaid Resource Limit For Home Care and Nursing Home

Single Person: $13,800

Couple: $20,100

Exempt Resources

Pre-paid funeral (no limit on value)
Car and Personal Effects
Home Max. Value of $750,000 *(primary residence)

*While exempt for eligibility purposes, a home may be subject to claims or liens by Medicaid, unless proper planning is put in place prior to the death of the Medicaid recipient.

Retirement Accounts (IRA-401K) of the applicant and the applicant's spouse. The applicant's retirement account must be paying out the minimum allowable distribution. (note: income from these accounts is not exempt and will be considered countable income)

Exempt Income

Certain income is not counted for eligibility purposes.

Restitution payments from Nazi persecution
Income diverted into a Pooled Income Trust (home care only)

Transfer Penalties for gifting your assets apply to nursing home care only .

There are only transfer penalties imposed for nursing home coverage, there are no penalties for community home care services (including pharmacy and doctor services). Therefore, you may transfer your assets this month and become Medicaid eligible the next month.

2010 Spousal Allowances

The non-applicant spouse is permitted to retain the following amounts when their spouse enters a nursing home with Medicaid coverage:

Well spouse Income : $2,739 per month from their combined income

Well Spouse Resources: $109,560 (approximate)

CLICK HERE: to visit "Medicaid Legal Information Letters" - detailed legal writings on the workings of the New York State Medicaid Program.

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To fully understand how to become eligible for Medicaid and how individuals with incomes and resources that exceed the limits described above can apply for coverage, please contact our office to make an appointment for a Medicaid planning consultation.