Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2024:
The resource level for the Medicaid applicant is $31,175. GIS 24 MA/01 Attachment.
This is an update from the 2024 resource level which had previously been announced.
Posted 02/16/2024.
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
HOME EQUITY LIMIT FOR 2024
The home equity limit for Medicaid coverage of nursing facility services is $1,071,000. GIS 23 MA/23, which is dated 12/29/2023.
For an explanation of how this rule works, see pages 13-14 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.
Posted 12/29/2023
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
INCOME LEVEL FOR 2024 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one is $1,677 per month for now. GIS 23 MA/23 and its attachment.
INCOME LEVEL FOR 2024 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one is $1,677 per month for now. GIS 23 MA/23 and its attachment.
INCOME LEVEL FOR 2024 – AFTER MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The person in the nursing home is allowed to keep a Personal Needs Allowance of $50 per month if they do not have a community spouse. GIS 23 MA/23 attachment.
INCOME LEVEL FOR 2024 – AFTER MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The person in the nursing home is allowed to keep a Personal Needs Allowance of $50 per month if they have a community spouse. GIS 23 MA/23 attachment.
INCOME LEVEL FOR 2024 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $3,853.50 per month. GIS 23 MA/23 and its attachment.
CHANGE IS COMING: GIS 23 MA/23 is dated 12/29/2023. It advises that the Medically Needy income level is based on a percentage of the Federal Poverty Level. When the 2024 Federal Poverty Level is announced, the Medically Needy income level will be updated. This is the level which is is used for Month One for a person in a nursing home who does not have a community spouse, and for Month One for a person in a nursing home who does have a community spouse.
Posted 12/29/2023
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2024:
The resource level for the Medicaid applicant remains at $30,182 for now. GIS 23 MA/23 and its Attachment.
RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2024:
The minimum resource level for the community spouse is $74,820 and the maximum is $154,140. GIS 23 MA/23 and its Attachment. For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.
CHANGE IS COMING: GIS 23 MA/23 is dated 12/29/2023. It advises that the Medically Needy resource level is based on a percentage of the Medically Needy income level, and the Medically Needy income level is based on a percentage of the Federal Poverty Level. When the 2024 Federal Poverty Level is announced, the Medically Needy resource level will be updated.
Posted 12/29/2023
The 2024 regional rates for calculating Medicaid penalty periods are found in GIS 23 MA/21, which is dated 12/26/2023. They are:
CENTRAL: $12,196
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.
NORTHEASTERN: $13,235
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.
WESTERN: $12,241
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.
NORTH METROPOLITAN: $14,165
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.
NEW YORK CITY: $14,273
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).
LONG ISLAND: $14,668
Nassau and Suffolk.
ROCHESTER: $14,419
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.
Posted 12/27/2023
GIS 23 MA/17, which is dated 08/29/2023, advises that there is a new Medicaid application form.
The new version of the Access NY Health Care Application will show this at the bottom of each page: (1/23).
The new version of the form is an attachment to the GIS.
It also may be found by going to: http://www.health.ny.gov/forms/doh-4220.pdf
If that link stops working, the form may be found on the New York State Department of Health website.
Go to www.health.ny.gov
Click on: Individuals/Families
Click on: Health Topics A to Z
Click on: the letter M
Click on: Medicaid
Click on: How to Apply (this will be on the left side of the screen)
Scroll down to: Medicaid Application for Non-MAGI Eligibility Group
Click on: DOH-4220
Posted 09/03/2023
There is a new life expectancy table to use when determining if an annuity, promissory note, loan or mortgage is actuarially sound.
GIS 23 MA-09, dated 04/11/2023, states that the life expectancy table in its attachment is to be used rather than the table which was attached to 06 OMM/ADM-5.
Posted 07/16/2023
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2023:
The resource level for the Medicaid applicant is $30,182. GIS 23 MA/02 Attachment.
RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2023:
The minimum resource level for the community spouse is $74,820 and the maximum is $148,620. GIS 22 MA/14 and its Attachment. These figures were not updated by GIS 23 MA/02 and its Attachment. For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.
Posted 02/15/2023
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
HOME EQUITY LIMIT FOR 2023
The home equity limit for Medicaid coverage of nursing facility services is $1,033,000. GIS 22 MA/14.
For an explanation of how this rule works, see pages 13-14 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.
Posted 12/30/2022
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2023:
The resource level for the Medicaid applicant is $28,133. GIS 22 MA/14 attachment.
RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2023:
The minimum resource level for the community spouse is $74,820 and the maximum is $148,620. GIS 22 MA/14 and its Attachment. For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.
Posted 12/30/2022