Nancy E Kline

GIS 24 MA/07, dated 07/25/2024, advises that the resource test will be waived for SSI-related recipients who are renewing Medicaid eligibility.  The resource test will be waived whether the person is in the community or in a nursing home.  The Medicaid caseworker processing the renewal will not send asset verification requests to the Asset Verification System (AVS).  If a person has been determined to be eligible for Medicaid, no action can be taken to discontinue Medicaid coverage due to excess resources, through 06/30/2025.

The resource test also will be waived, through 06/30/2025, for people who have Medicaid Community Coverage without Long Term Care, and who ask for their coverage to be increased to Medicaid Community Coverage With Long Term Care.

However, the resource test is not waived for people who are newly applying for Medicaid.  Furthermore, the resource test is not waived for people who have Medicaid Community Coverage and are asking to have their coverage increased to include nursing home care.  In those situations, the Medicaid caseworker will send asset verification requests to the Asset Verification System.

There is no change to the lookback requirements.  There is no change to the transfer of assets rules.

The GIS has an attachment, which is a chart showing which tests apply for different types of requests.

For an explanation of Medicaid categories, such as “SSI-related,” see page 2 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.

Posted 07/31/2024.

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:

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

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