NY Medicaid – Nancy E Kline

New Medicaid Application Form

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Dec 192021

GIS 21 MA/22, dated 12/15/2021, advises that the Medicaid application form has been revised.

The new form, DOH-4220 (8/21) is attached to the GIS. The new form also may be found by going to the New York State Department of Health website at: www.health.ny.gov

Click on Individuals/Families

Health Topics A-Z

Medicaid

Scroll down past What do I need to apply for Medicaid?

Under DOH-4220, click on the appropriate language

The old form had 4 photos on the front and was dated 3/15. It was called, “Access NY Health Care Health Insurance Application for Children, Adults and Families.”

The new form has 3 photos on the front and is dated 8/21. It is called, “Access NY Health Care Health Insurance for Older Adults, People With Disabilities and Certain Other Populations Application.”

Posted 12/19/2021

New Life Expectancy Table

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Oct 102021

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

GIS 21 MA/19, dated 10/08/2021, 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 10/10/2021

New Life Expectancy Table

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Aug 272020

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

GIS 20 MA/08, dated 08/25/20, 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 08/27/2020

Substantial Home Equity Limit for 2020

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Dec 212019

The Substantial Home Equity Limit for 2020 is 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:

HOME EQUITY LIMIT FOR 2020
The home equity limit for Medicaid coverage of nursing facility services is $893,000 for 2020. GIS 19 MA/12, 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.

Posted 12/21/2019

Substantial Home Equity Limit for 2019

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Dec 092018

The Substantial Home Equity Limit for 2019 is shown in GIS 18 MA/15, which is dated 12/7/18.

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

HOME EQUITY LIMIT FOR 2019
The home equity limit for Medicaid coverage of nursing facility services is $878,000 for 2019. GIS 18 MA/15, 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.

Posted 12/09/2018

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

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

Transfer of Assets (Gifting) Comments Off

Jan 022016

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 2016 are found in GIS 15 MA/23. The GIS tells you which counties are in which region.

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.

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