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Regional Rates for 2015

Transfer of Assets (Gifting) Comments Off

Feb 032015

Page 54 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes how to calculate a penalty period when someone has made a gift. You need to know the regional rate in order to calculate the penalty period. The regional rates for 2015 are found in GIS 15 MA/01. The GIS tells you which counties are in which region. It reminds you to use the rate for the region in which the facility is located.

The 2015 regional rates are:

CENTRAL: $8,768
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins counties.

NORTHEASTERN: $9,414
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington counties.

WESTERN: $9,422
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming counties.

NORTHEASTERN METROPOLITAN:$11,455
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester counties.

NEW YORK CITY: $11,843
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $12,390
Nassau and Suffolk counties.

ROCHESTER: $10,660
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates counties.

Income Levels for 2015

Income Comments Off

Jan 082015

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

INCOME LEVEL FOR 2015 — 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 2015 is $825 per month. GIS 14 MA/29.

INCOME LEVEL FOR 2015 — MONTH ONE — PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2015 is $825 per month. GIS 14 MA/29.

INCOME LEVEL FOR 2015 — 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 2015 if he does not have a community spouse.

INCOME LEVEL FOR 2015 — 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 2015 if he does have a community spouse.

INCOME LEVEL FOR 2015 — COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $2,980.50 per month for 2015. GIS 14 MA/29.

INCOME LEVEL FOR 2015 — LONG TERM HOME HEALTH CARE PROGRAM PARTICIPANT
The participant in a Long Term Home Health Care Program (also referred to as the “Lombardi Program” and the “Nursing Home Without Walls Program”) is allowed to keep a Personal Needs Allowance for Certain Waiver Participants Subject to Spousal Impoverishment Budgeting of $384 per month for 2015. GIS 14 MA/29.

New Life Expectancy Table

Resources Comments Off

Jan 082015

There is a new life expectancy table to use when determining if an annuity, loan, promissory note or mortgage is actuarially sound. GIS 14 MA/28 states that the life expectancy table in its attachment is to be used in place of the life expectancy table at 06 OMM/ADM-5.

Resource Levels for 2015

Resources Comments Off

Jan 082015

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2015:
The resource level for the Medicaid applicant is $14,850 for the year 2015. GIS 14 MA/29.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2015:
For 2015, the minimum resource level for the community spouse is $74,820 and the maximum is $119,220. GIS 14 MA/29. For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.

Substantial Home Equity Limit for 2015

Resources Comments Off

Jan 082015

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

HOME EQUITY LIMIT FOR 2015:
The home equity limit for Medicaid coverage of nursing facility services is $828,000 for 2015. GIS 14 MA/29.

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.

New Life Expectancy Table

Resources Comments Off

Mar 072014

There is a new life expectancy table to use when determining if an annuity, loan, promissory note or mortgage is actuarially sound. GIS 13 MA/020 states that the life expectancy table in its attachment is to be used in place of the life expectancy table at 06 OMM/ADM-5. This GIS was issued in 2013. Note that GIS 12 MA/025, which had an updated table, was issued in 2012.

Regional Rates for 2014

Transfer of Assets (Gifting) Comments Off

Jan 222014

Page 54 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes how to calculate a penalty period when someone has made a gift. You need to know the regional rate in order to calculate the penalty period. The regional rates for 2014 are found in GIS 14 MA/03. The GIS tells you which counties are in which region. It reminds you to use the rate for the region in which the facility is located. The GIS may be found at the New York State Department of Health website: health.ny.gov.

The 2014 regional rates are:

CENTRAL: $8,645
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins Counties

NORTHEASTERN: $9,212
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties

WESTERN: $8,971
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming Counties

NORTHEASTERN METROPOLITAN: $11,135
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester Counties

NEW YORK CITY: $11,423
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island)

LONG ISLAND: $12,112
Nassau and Suffolk Counties

ROCHESTER: $10,073
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates Counties

Substantial Home Equity Limit for 2014

Resources Comments Off

Dec 272013

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

HOME EQUITY LIMIT FOR 2014:
The home equity limit for Medicaid coverage of nursing facility services is $814,000 for 2014. GIS 13 MA/022, page 3.

Note that it was $803,000 for the year 2013. GIS 13 MA/02, page 3.

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.

Resource Levels for 2014

Resources Comments Off

Dec 272013

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2014:
The resource level for the Medicaid applicant is $14,550 for the year 2014. GIS 13 MA/022, page 2 and Attachment 2. Note that Attachment 1 lists the amount as $14,400, which was the 2013 amount; I assume this is a typo.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2014:
For 2014, the minimum is $74,820 and the maximum is $117,240. GIS 13 MA/022, page 3 and Attachment 1.
For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.

Income Levels for 2014

Income Comments Off

Dec 272013

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

INCOME LEVEL FOR 2014 – 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 2014 is $809 per month. GIS 13 MA/022, page 2 and Attachment 2.

INCOME LEVEL FOR 2014 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2014 is $809 per month. GIS 13 MA/022, page 2 and Attachment 2.

INCOME LEVEL FOR 2014 – 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 2014 if he does not have a community spouse. GIS 13 MA/022, Attachment 1.

INCOME LEVEL FOR 2014 – 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 2014 if he does have a community spouse. GIS 13 MA/022, Attachment 1.

INCOME LEVEL FOR 2014 – COMMUNITY SPOUSE
The community spouse is allowed to keep $2,931 per month of income for 2014. GIS 13 MA/022, page 3 and Attachment 1.

INCOME LEVEL FOR 2014 – LONG TERM HOME HEALTH CARE PROGRAM PARTICIPANT
The participant in a Long Term Home Health Care Program (also referred to as the “Lombardi Program” and “The Nursing Home Without Walls Program”) is allowed to keep a Personal Needs Allowance for Certain Waiver Participants Subject to Spousal Impoverishment Budgeting of $383 per month for 2014. GIS 13 MA/022, page 3.

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