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It’s important to stay informed about changes to the Medicaid Long-term Care program and its eligibility requirements. Long-term care can be costly, and Medicaid is a critical resource for eligible individuals who need assistance with the cost of their care.
In this article, we will provide a comprehensive guide on how to apply for New York Medicaid Long-term Care in 2023, including eligibility criteria, the application process, and any changes to the program. Understanding these changes is crucial to ensure proper coverage for long-term care needs.
2023 New York Medicaid Income and Asset Limits
To be eligible for Medicaid Long-term Care in New York in 2023, income cannot exceed $1,697 (for a single), or $2,288 (for a couple). This represents a significant increase from $954 (for a single person) or $1,387 (for a couple) in 2022.
The total assets cannot exceed $30,182 (for a single), or $40,821 (for a couple), excluding certain exempt assets like a primary residence, household goods, and a vehicle. It is important to note that a primary residence is only exempt when at least one spouse resides there. If both spouses are admitted to a nursing home or die, Medicaid can collect the costs of the care from the house’s value.
What if my assets exceed the limit in 2023?
If your assets exceed the above limits, you may still qualify for Medicaid Long-term Care through a variety of methods.
- Spend down excess assets: One common strategy for becoming eligible for Medicaid Long-term Care is to “spend down” excess assets on permissible expenses. These expenses may include medical bills, dental care, hearing aids, personal care items, home modifications, or prepaying funeral expenses.
- Gifting: Another way to reduce your countable assets is to give assets to family members or others. However, it’s essential to be cautious when using this strategy, as Medicaid has a” look-back period”. Any gifts or transfers made within this period may result in penalties or disqualification from Medicaid benefits.
In New York, there is no look-back period for homecare, allowing applicants to qualify immediately after giving away their assets. As I discussed in previous articles, the new law established a 2.5-year look-back period, which is expected to begin soon after the current It is important to consult with an elder lawyer before making gifts to qualify for Medicaid Long-term care.
- Irrevocable Medicaid trust: Establishing an irrevocable Medicaid trust can help protect your assets while still qualifying for Medicaid Long-term Care. By transferring assets to the trust, they are no longer considered part of your countable assets. However, keep in mind that the transfer of assets may be subject to a look-back period, during which Medicaid can penalize you for transferring assets.
- Spousal refusal: In 2023, a spouse who does not require long-term care may still refuse financial support for their partner seeking Medicaid assistance. This can allow the applicant to qualify for Medicaid while protecting the other spouse’s assets and income.
What if my income exceeds the limit in 2023?
You can set up a “pooled income trust” to deposit your surplus income into the trust to effectively lower your countable income to meet Medicaid’s income limit. The trust can then pay for your monthly expenses, such as rent, utilities, and food. You need to be approved by Medicaid to use a pooled income trust and you can only deposit unearned income, such as social security benefits, pension, or dividends.
Medicaid application process in 2023
Before the new 2.5-year lookback period begins after the end of the covid public health emergency, applicants for community Medicaid, which covers homecare and daycare, must submit only one month’s financial records. When the new lookback period is implemented, applicants will be required to submit financial records dating back 2.5 years.
Medical assessments in 2023
Medical assessments are an important part of the Medicaid application process because they evaluate medical needs for long-term care.
New laws were passed in 2020 requiring a higher level of medical need to qualify for long-term care. Rather than the current two ADLs, an applicant must demonstrate that he or she requires assistance with at least three ADLs (activities of daily living – dressing, bathing, toileting, walking, eating, transfer, turn, and positioning).
When the current public health emergency ends, new laws with stricter criteria will go into effect.
Annual Recertification in 2023
During the public health emergency, there was a moratorium on Medicaid case closures or reductions. All Medicaid cases could be continued without the need for annual recertification. Medicaid did not even send recertification notices to many recipients. However, this is coming to an end, and Medicaid will resume mailing notices to everyone in April of this year. It plans to begin closing cases in June or July if a recertification is not received.
The Medicaid income limit is greatly increased in 2023. As a result, many recipients who had excess income to spend down by paying in or using a pooled trust are no longer required to do so. Counties are allowing such recipients to rebudget their spend-down before their annual recertification so they can pay less or close a pooled trust.
In summary, do not hesitate to explore the New York Medicaid Long-term Care program if you or a family member needs long-term care. By taking a proactive approach and engaging in this process, you can secure long-term care services that can significantly improve the quality of life for those in need. As you navigate the application process, be sure to consult with an elder lawyer who can guide you to make a better decision for the family.
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