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
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
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
There is a new life expectancy table to use when determining if an annuity, promissory note, loan or mortgage is actuarially sound.
GIS 22 MA-06, dated 07/15/2022, 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 07/20/2022
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
HOME EQUITY LIMIT FOR 2022
The home equity limit for Medicaid coverage of nursing facility services is $955,000 for the year 2022. GIS 21 MA/25.
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 01/19/2022
The 2022 regional rates for calculating Medicaid penalty periods are found in GIS 21 MA/26, which is dated 12/30/2021. They are:
CENTRAL: $11,328
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.
NORTHEASTERN: $12,560
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.
WESTERN: $11,884
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.
NORTH METROPOLITAN: $13,399
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.
NEW YORK CITY: $13,415
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).
LONG ISLAND: $14,012
Nassau and Suffolk.
ROCHESTER: $13,376
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.
Posted 12/31/2021
Medicaid income levels for the year 2022 are shown in GIS 21 MA/25, which is dated 12/28/21, and its Attachment I.
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
INCOME LEVEL FOR 2022 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2022 is $934 per month. GIS 21 MA/25 and its Attachment I.
INCOME LEVEL FOR 2022 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2022 is $934 per month. GIS 21 MA/25 and its Attachment I.
INCOME LEVEL FOR 2022 – 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 for 2022 if they do not have a community spouse. GIS 21 MA/25, Attachment I.
INCOME LEVEL FOR 2022 – 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 for 2022 if they have a community spouse. GIS 21 MA/25, Attachment I.
INCOME LEVEL FOR 2022 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $3,435 per month for 2022. GIS 21 MA/25 and its Attachment I.
Posted 12/29/2021
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2022:
The resource level for the Medicaid applicant is $16,800. GIS 21 MA/25 and its Attachment I.
RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2022:
The minimum resource level for the community spouse is $74,820 and the maximum is $137,400. GIS 21 MA/25 and its Attachment I. For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibilty Rules for Nursing Home Care in New York State.
Posted 12/29/2021
GIS 21 MA/22, dated 12/15/2021, advises that the Medicaid application form has been revised.
The new form, DOH-4220 (8/21) is attached to the GIS. The new form also may be found by going to the New York State Department of Health website at: www.health.ny.gov
Click on Individuals/Families
Health Topics A-Z
M
Medicaid
Scroll down past What do I need to apply for Medicaid?
Under DOH-4220, click on the appropriate language
The old form had 4 photos on the front and was dated 3/15. It was called, “Access NY Health Care Health Insurance Application for Children, Adults and Families.”
The new form has 3 photos on the front and is dated 8/21. It is called, “Access NY Health Care Health Insurance for Older Adults, People With Disabilities and Certain Other Populations Application.”
Posted 12/19/2021