Income Levels for 2020

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Dec 212019
 

Medicaid income levels for the year 2020 are shown in GIS 19 MA/12, which is dated 12/19/19.

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

INCOME LEVEL FOR 2020 – 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 2020 is $875 per month. GIS 19 MA/12, page 2.

INCOME LEVEL FOR 2020 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2020 is $875 per month. GIS 19 MA/12, page 2.

INCOME LEVEL FOR 2020 – 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 Perseonal Needs Allowance of $50 per month for 2020 if they do not have a community spouse. GIS 19 MA/12, Attachment 1.

INCOME LEVEL FOR 2020 – 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 2020 if they have a community spouse. GIS 19 MA/12, Attachment 1.

INCOME LEVEL FOR 2020 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $3,216 per month for 2020. GIS 19 MA/12, page 2 and Attachment 1.

Posted 12/21/2019

New Life Expectancy Table

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Jun 162019
 

There is a new life expectancy table to use when determining if an annuity, promissory note, loan or mortgage is actuarially sound.

GIS 19 MA/07, dated 05/23/19, 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.

Regional Rates for 2019

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Jan 032019
 

The 2019 regional rates for calculating Medicaid penalty periods are found in GIS 19 MA/01, which is dated 01/03/2019. They are:

CENTRAL: $10,068
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.

NORTHEASTERN: $11,280
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.

WESTERN: $10,556
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.

NORTH METROPOLITAN: $12,636
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.

NEW YORK CITY: $12,419
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $13,407
Nassau and Suffolk.

ROCHESTER: $12,342
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.

Posted 01/03/2019

New Life Expectancy Table

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Aug 312018
 

There is a new life expectancy table to use when determining if an annuity, promissory note, loan or mortgage is actuarially sound.

GIS 18 MA/08, dated 6/21/18, 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.

Substantial Home Equity Limit for 2018

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Jan 042018
 

The Substantial Home Equity Limit for 2018 is shown in GIS 17 MA/20, which is dated 12/28/17. PLEASE NOTE: I have been told that on 01/03/18, local social service districts were notified that there is an error. The spousal impoverishment figures and statement in Attachment I of the GIS are incorrect. However, the figures in the text of the GIS itself are correct.

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

HOME EQUITY LIMIT FOR 2018
The home equity limit for Medicaid coverage of nursing facility services is $858,000 for 2018. GIS 17 MA/20, 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.

Posted 01/03/18

Income Levels for 2018

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Jan 042018
 

Medicaid income levels for the year 2018 are shown in GIS 17 MA/20, which is dated 12/28/17. PLEASE NOTE: I have been told that on 01/03/18, local social service districts were notified that there is an error. The spousal impoverishment figures and statement in Attachment I of the GIS are incorrect. However, the figures in the text of the GIS itself are correct. By 01/16/18, the figures in Attachment I of the GIS had been corrected.

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

INCOME LEVEL FOR 2018 – 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 2018 is $842 per month. GIS 17 MA/20, page 2.

INCOME LEVEL FOR 2018 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE.
The Medically Needy Income Level for a household of one for 2018 is $842 per month. GIS 17 MA/20, page 2.

INCOME LEVEL FOR 2018 – 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 2018 if they do not have a community spouse. GIS 17 MA/20, Attachment I.

INCOME LEVEL FOR 2018 – 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 2018 if they have a community spouse. GIS 17 MA/20, Attachment I.

INCOME LEVEL FOR 2018 – COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $3,090 per month for 2018. GIS 17 MA/20, page 3.

Posted 01/03/18

Resource Levels for 2018

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Jan 042018
 

Medicaid resource levels for the year 2018 are shown in GIS 17 MA/20, which is dated 12/28/17. PLEASE NOTE: I have been told that on 01/03/18, local social services districts were notified that there is an error. The spousal impoverishment figures and statement in Attachment I of the GIS are incorrect. However, the figures in the text of the GIS itself are correct. By 01/16/18, the figures in the Attachment had been corrected.

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2018:
For 2018, the resource level for the Medicaid applicant is $15,150. GIS 17 MA/20, page 2.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2018:
For 2018, the minimum resource level for the community spouse is $74,820 and the maximum is $123,600. GIS 17 MA/20, page 3. 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 01/04/18

Regional Rates for 2018

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Dec 052017
 

The 2018 regional rates for calculating Medicaid penalty periods are found in GIS 17 MA/19. They are:

CENTRAL: $9,722
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.

NORTHEASTERN: $10,719
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.

WESTERN: $10,239
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.

NORTH METROPOLITAN: $12,428
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.

NEW YORK CITY: $12,319
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $13,053
Nassau and Suffolk.

ROCHESTER: $11,692
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.

Posted 12/05/2017

New Life Expectancy Table

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Nov 072017
 

There is a new life expectancy table to use when determining if an annuity, promissory note, loan or mortgage is actuarially sound.

GIS 17 MA/16, dated 10/27/17, 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.

Substantial Home Equity Limit for 2016

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Jan 022016
 

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

HOME EQUITY LIMIT FOR 2016:
The home equity limit for Medicaid coverage of nursing facility services is $828,000 for 2016. There is no change from 2015. GIS 15 MA/21, page 2.

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.

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