2016 New York Medicaid Changes

By:  Shane M. McCrohan


  1. No Changes to Resource and Income Limits

The 2016 New York Medicaid resource and income limits for both single individuals and married couples will remain the same as the 2015 limits.

Resource Limits:

Type of Medicaid Single Married Couple
Home Care $14,850 $21,750
Nursing Home $14,850 $134,070 [1]

The resource limits to refer to the maximum amount of non-exempt resources allowed to be owned by the Medicaid applicant and his/her spouse, if applicable.

Home Equity Limit for Primary Residence:  $828,000 for all Medicaid types

The home equity limit does not apply if the Primary Residence is occupied by the Medicaid applicant’s spouse, minor child or blind or disabled child.

Monthly Income Limits:

Type of Medicaid Single Married Couple
Home Care [2] $825 $1,245.00
Nursing Home $50 $3,030.50 [3]

The income limits refer to the maximum amount of income left after deducting medical expenses.  In 2016, a single individual applying for Home Care Medicaid with monthly medical expenses of $3,000 generally cannot have more than $3,825 of monthly income.  A married couple applying for Home Care Medicaid with monthly medical expenses of $4,000 generally cannot have more than $5,245 of monthly income.  The income limits for Nursing Home Medicaid are usually not a concern because, in most cases, the monthly nursing home expenses greatly exceed monthly income.

  1. Increase in Regional Rates for Computing Transfer Penalty Period

Medicaid generally imposes a transfer penalty period for any gifts made by the Medicaid applicant or his/her spouse within the five year look back period.  The transfer penalty period is the number of months in which the Medicaid applicant will be ineligible for Medicaid assistance.  The transfer penalty period is computed by dividing the value of the gift by a regional rate. The regional rate to be used depends on the region in which the Medicaid applicant resides.

The 2016 regional rates used in computing the transfer penalty period have increased from the 2015 levels.

Regional Rates:

Region Monthly Rate Counties
Central $9,252 Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins
Rochester $11,145 Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates
Western $9,630 Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming
Northeastern $9,806 Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington
Northern Metropolitan $11,768 Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester
New York City $12,029 Bronx, Kings (Brooklyn), New York (Manhattan), Queens, Richmond (Staten Island)
Long Island $12,633 Nassau, Suffolk

   

                 To learn more, please contact Shane McCrohan or to view our complete Memorandum on the Medicaid eligibility, please click here.

           

    

 

[1] Institutionalized spouse limit of $14,850 plus community spouse maximum limit of $119,220.
[2] Does not include the $20 unearned income allowance.
[3] Institutionalized spouse limit of $50 plus community spouse maximum limit of $2,980.50.

 

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