December 2022

Substantial Home Equity Limit for 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

Resource Levels for 2023 – Original

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

Income Levels for 2023

Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:

INCOME LEVEL FOR 2023 – 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 $1,563 per month. GIS 22 MA/11; GIS 22 MA/14 and its attachment.

INCOME LEVEL FOR 2023 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one is $1,563 per month. GIS 22 MA/11; GIS 22 MA/14 and its attachment.

INCOME LEVEL FOR 2023 – 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 22 MA/14 attachment.

INCOME LEVEL FOR 2023 – 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 22 MA/14 attachment.

INCOME LEVEL FOR 2023 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $3,715.50 per month.  GIS 22 MA/14 and its attachment.

Posted 12/30/2022

Regional Rates for 2023

The 2023 regional rates for calculating Medicaid penalty periods are found in GIS 22 MA/12, which is dated 12/5/2022. They are:

CENTRAL: $11,726
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.

NORTHEASTERN: $12,744
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.

WESTERN: $12,130
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.

NORTH METROPOLITAN: $13,906
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.

NEW YORK CITY: $14,142
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $14,136
Nassau and Suffolk.

ROCHESTER: $13,421
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.

Posted 12/06/2022