New York Medicaid – Nancy E Kline

Resource Levels for 2020

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Dec 212019

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

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2020:
For 2020, the resource level for the Medicaid applicant is $15,750. GIS 19 MA/12, page 2 and Attachment 1.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2020:
For 2020, the minimum resource level for the community spouse is $74,820 and the maximum is $128,640. GIS 19 MA/12, page 2 and Attachment 1. 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 12/21/2019

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.

Resource Levels for 2017

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Dec 262016

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2017:
For 2017, the resource level for the Medicaid applicant is $14,850. There is no change from 2015 or 2016. GIS 16 MA/18, page 2 and Attachment.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2017:
For 2017, the minimum resource level for the community spouse is $74,820 and the maximum is $120,900. GIS 16 MA/18, page 2 and 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.

Regional Rates for 2017

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Dec 142016

Page 54 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes how to calculate a penalty period when someone has made a gift. You need to know the regional rate in order to calculate the penalty period. The regional rates for 2017 are found in GIS 16 MA/16. The GIS tells you which counties are in which region.

The GIS reminds you to use the regional rate which is in effect as of the date of the application, for the region in which the facility is located.

The 2017 regional rate are:

CENTRAL: $9,511
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.

NORTHEASTERN: $10,242
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Oswego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington.

WESTERN: $10,078
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.

NORTH METROPOLITAN: $12,198
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester.

NEW YORK CITY: $12,157
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $12,811
Nassau and Suffolk.

ROCHESTER: $11,237
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.

New Life Expectancy Table

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Dec 142016

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

GIS 16 MA/10 stated that the life expectancy table in its attachment is to be used in place of the life expectancy table at 06 OMM/ADM-5. The heading on the attachment is, “2015 Life Expectancy Table.”

GIS 16 MA/15 stated that the life expectancy table in its attachment is to be used in place of the life expectancy table at 06 OMM/ADM-5. The heading on the attachment is, “2016 Life Expectancy Table.”

Regional Rates for 2016

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Jan 022016

GIS 15 MA/23 advises of a change regarding which regional rate to use. In the past, you used the regional rate in effect on the “pick-up date” (the date you wanted Medicaid coverage to start). Now you use the rate in effect on the date that the application is filed. The GIS gives an example. If the application is filed in February 2016, and the application requests coverage beginning in November 2015, you need to use the 2016 regional rate. This rule is “effective immediately.” The GIS is dated 12/23/15.

GIS 15 MA/01, which contained the 2015 regional rates, reminded people to use the rate for the region in which the facility is located.

The 2016 regional rates are:

CENTRAL: $9,252
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins counties.

NORTHEASTERN: $9,806
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington counties.

WESTERN: $9,630
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming counties.

NORTHERN METROPOLITAN:$11,768
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester counties.

NEW YORK CITY: $12,029
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $12,633
Nassau and Suffolk counties.

ROCHESTER: $11,145
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates counties.

Resource Levels for 2016

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Jan 022016

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

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2016:
For 2016, the resource level for the Medicaid applicant is $14,850. There is no change from 2015. GIS 15 MA/21.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2016:
For 2016, the minimum resource level for the community spouse is $74,820 and the maximum is $119,220. There is no change from 2015. GIS 15 MA/21. For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.

Income Levels for 2015

Income Comments Off

Jan 082015

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

INCOME LEVEL FOR 2015 — 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 2015 is $825 per month. GIS 14 MA/29.

INCOME LEVEL FOR 2015 — MONTH ONE — PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2015 is $825 per month. GIS 14 MA/29.

INCOME LEVEL FOR 2015 — 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 2015 if he does not have a community spouse.

INCOME LEVEL FOR 2015 — 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 2015 if he does have a community spouse.

INCOME LEVEL FOR 2015 — COMMUNITY SPOUSE
The community spouse is allowed to keep a Minimum Monthly Maintenance Needs Allowance of $2,980.50 per month for 2015. GIS 14 MA/29.

INCOME LEVEL FOR 2015 — LONG TERM HOME HEALTH CARE PROGRAM PARTICIPANT
The participant in a Long Term Home Health Care Program (also referred to as the “Lombardi Program” and the “Nursing Home Without Walls Program”) is allowed to keep a Personal Needs Allowance for Certain Waiver Participants Subject to Spousal Impoverishment Budgeting of $384 per month for 2015. GIS 14 MA/29.

Regional Rates for 2014

Transfer of Assets (Gifting) Comments Off

Jan 222014

Page 54 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes how to calculate a penalty period when someone has made a gift. You need to know the regional rate in order to calculate the penalty period. The regional rates for 2014 are found in GIS 14 MA/03. The GIS tells you which counties are in which region. It reminds you to use the rate for the region in which the facility is located. The GIS may be found at the New York State Department of Health website: health.ny.gov.

The 2014 regional rates are:

CENTRAL: $8,645
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins Counties

NORTHEASTERN: $9,212
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties

WESTERN: $8,971
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming Counties

NORTHEASTERN METROPOLITAN: $11,135
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester Counties

NEW YORK CITY: $11,423
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island)

LONG ISLAND: $12,112
Nassau and Suffolk Counties

ROCHESTER: $10,073
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates Counties

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