December 2020 – Nancy E Kline

Substantial Home Equity Limit for 2021

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Dec 312020

The Substantial Home Equity Limit for the year 2021 is shown in GIS 20 MA/13, which is dated 12/30/20.

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

HOME EQUITY LIMIT FOR 2021
The home equity limit for Medicaid coverage of nursing facility services is $906,000 for the year 2021. GIS 20 MA/13.

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 12/31/2020

Income Levels for 2021

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Dec 312020

Medicaid income levels for the year 2021 are shown in GIS 20 MA/13, which is dated 12/30/20.

Please note that there are attachments to the GIS. When the GIS originally was posted to the New York State Department of Health website, it included an attachment which had not been updated to include the changes for the year 2021. An updated Attachment I was later posted to the NYSDOH website. The incorrect attachment shows that it was revised on November 9, 2020. The revised attachment shows that it was revised on December 30, 2020.

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

INCOME LEVEL FOR 2021 – 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 2021 is $884 per month. GIS 20 MA/13 and its Attachment I.

INCOME LEVEL FOR 2021 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2021 is $884 per month. GIS 20 MA/13 and its Attachment I.

INCOME LEVEL FOR 2021 – 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 2021 if they do not have a community spouse. GIS 20 MA/13, Attachment I.

INCOME LEVEL FOR 2021 – 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 2021 if they have a community spouse. GIS 20 MA/13, Attachment I.

INCOME LEVEL FOR 2021 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $3,259.50 per month for 2021. GIS 20 MA/13 and its revised Attachment I.

Posted 12/31/2020. Updated 01/01/2021.

Resource Levels for 2021

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Dec 312020

Medicaid resource levels for the year 2021 are shown in GIS 20 MA/13, which is dated 12/30/20.

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2021:
The resource level for the Medicaid applicant is $15,900. GIS 20 MA/13 and its revised Attachment I.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2021:
The minimum resource level for the community spouse is $74,820 and the maximum is $130,380. GIS 20 MA/13 and its revised 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 12/31/2020. Updated 01/01/2021.

Regional Rates for 2021

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Dec 292020

The 2021 regional rates for calculating Medicaid penalty periods are found in GIS 20 MA/12, which is dated 12/28/2020. They are:

CENTRAL: $10,857
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.

NORTHEASTERN: $11,689
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.

WESTERN: $11,054
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.

NORTH METROPOLITAN: $13,206
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.

NEW YORK CITY: $13,037
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $13,834
Nassau and Suffolk.

ROCHESTER: $13,020
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.

Posted 12/29/2020

Extension of Medicaid Application Process & Recertification Changes Due to COVID-19

COVID-19 PANDEMIC CAUSES CHANGES TO RULES AND LAWS Comments Off

Dec 172020

GIS 20 MA/11, dated 12/15/2020,advises that on October 2, 2020, the federal government announced that the COVID-19 public health emergency has been extended through January 20, 2021.

The changes to Medicaid eligibilty and enrollment outlined in GIS 20 MA/04 will remain in effect through that time.

The Recertification process also has changed due to the COVID-19 public health emergency.
Medicaid coverage has been extended automatically; recipients have not needed to do Recertification paperwork.

If an Upstate New York recipient’s Medicaid coverage ended or will end in October 2020, November 2020, December 2020, January 2021 or February 2021: coverage has been extended for 12 months. If an Upstate New York recipient’s Medicaid coverage will end in March 2021: coverage will be extended on December 29, 2020.

If a New York City recipient’s Medicaid coverage ended in October 2020, November 2020 or December 2020: coverage has been extended for 12 months. If a New York City recipient’s Medicaid coverage will end in January 2021, February 2021 or March 2021: it will be extended for 12 months around the 18th of the expiration month.

Posted 12/17/2020