Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:
INCOME LEVEL FOR 2026 – 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 $1,800 per month for now. GIS 26 MA/03 Attachment. In the first Non-MAGI Population page of the Attachment, look for the Monthly amount of Medicaid Income at 138% FPL for a household size of one in the chart at the top. In the second Non-MAGI Population page of the Attachment, look for the SSI-Related amount for a household of one.
INCOME LEVEL FOR 2026 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one is $1,800 per month for now. GIS 26 MA/03 Attachment. In the first Non-MAGI Population page of the Attachment, look for the Monthly amount of Medicaid Income at 138% FPL for a household size of one in the chart at the top. In the second Non-MAGI Population chart of the Attachment, look for the SSI-Related amount for a household of one.
INCOME LEVEL FOR 2026 – 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. In the first Non-MAGI Population page of the attachment to GIS 26 MA/03, look for the Institutionalized Spouse’s income in the Spousal Impoverishment chart.
INCOME LEVEL FOR 2026 – 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. In the first Non-MAGI Population page of the attachment to GIS 26 MA/03, look for the Institutionalized Spouse’s income in the Spousal Impoverishment chart.
INCOME LEVEL FOR 2026 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $4,066.50 per month. GIS 26 MA/03 and its attachment. In the first Non-MAGI Population page of the attachment to GIS 26 MA/03, look for the Community Spouse’s income in the Spousal Impoverishment chart.
CHANGE IS COMING: GIS 26 MA/03 is dated 01/23/2026. The Medically Needy income level is based on a percentage of the Federal Poverty Level. When the 2026 Federal Poverty Level is published in the Federal Register, the Medically Needy Income Level will be updated. This is the level which is used for Month One for a person in a nursing home who does not have a community spouse, and for Month One for a person in a nursing home who does have a community spouse.
Posted 01/24/2026
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