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2016 New York Medicaid Changes
2016 New York Medicaid Changes
By: Shane M. McCrohan
- No Changes to Resource and Income Limits
- Increase in Regional Rates for Computing Transfer Penalty Period.
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.
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.
- Institutionalized spouse limit of $14,850 plus community spouse maximum limit of $119,220.
- Does not include the $20 unearned income allowance.
- Institutionalized spouse limit of $50 plus community spouse maximum limit of $2,980.50.
