Resource Levels for 2023 – Original

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Dec 302022
 

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

Income Levels for 2023

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Dec 302022
 

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

Regional Rates for 2023

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Dec 062022
 

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

New Life Expectancy Table

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Jul 202022
 

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

Substantial Home Equity Limit for 2022

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Jan 192022
 

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

Regional Rates for 2022

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Dec 312021
 

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

Income Levels for 2022

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Dec 292021
 

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

Resource Levels for 2022

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Dec 292021
 

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

Stimulus Payment Under ARPA of 2021

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Apr 152021
 

GIS 21 MA/07, dated 04/14/2021, says that the American Rescue Plan Act of 2021 (ARPA) was signed into law on 03/11/2021. Section 9061 authorizes a refundable tax credit for 2021 to eligible individuals. This “recovery rebate” or “stimulus payment” is up to $1,400 for single adults, $2,800 for married couples filing jointly and $1,400 for each child under age 17. For Medicaid purposes for people in the non-MAGI category (such as SSI-related people in nursing homes), these payments are not countable income. These payments are an exempt resource for 12 months. After 12 months, any portion of the payment which remains is a countable resource.

Posted 04/15/2021

Second Stimulus Payment Under Cares Act

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Jan 202021
 

GIS 21 MA/01, dated 01/19/21, says that for non-MAGI determinations (such as SSI-related people in nursing homes), the second stimulus payment received under the CARES Act is not countable as income. It is an exempt resource for 12 months. After the 12-month period, any part of the payment which remains is a countable resource.

Posted 01/20/2021

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