Medicaid In New York – Part I

Medicaid was established in 1965 by an act of Congress. Medicaid is designed to deal with healthcare issues for individuals and families who cannot afford healthcare. Individuals applying for medicaid must meet minimum coverage requirements. These requirements are the individual must be under 21 years of age or over 65 years of age or be eligible for public assistance or recipient of Social Security Disability, blind and/or disabled. There are two types of medicaid, home-care and long term care in nursing homes.

Medicaid Administrated in New York State on the County Level

In the State of New York, Medicaid programs are administrated by each individual county. In the City of New York, Medicaid is administrated by the Human Resources Administration. In counties outside the State of New York, Medicaid is usually administrated by the Department of Social Services.

Eligibility for Medicaid

The resource amount for Medicaid is currently $14,250. Married couples can have combined exempt resources of $20,850. When one spouse goes into a nursing home the remaining spouse (referred to as the community spouse) can keep $113,640 in assets.

There are certain resources that are exempt from Medicaid. Individuals can set up an irrevocable funeral trust for their final expenses and these funds are exempt from Medicaid. For community Medicaid (the individual living at their residence) the equity in a home may not exceed $786,000. Medicaid can still recover against the equity in the home after the individual receiving the Medicaid benefits dies. Medicaid accomplishes collecting against the value of a home by placing a lien on the home for the costs they incur in maintaining the Medicaid recipient. An exception to Medicaid placing a lien on a home, is if the home is the principal residence of the Medicaid recipient’s spouse and/or minor children. The spouse needs to have lived in the home for a minimum of one year prior to the individual’s admission to a medical facility.

Individual Retirement Accounts and Medicaid

Individual retirement accounts or other types of retirement accounts are exempt if the individuals are receiving regular, periodic payments from these accounts. However, the funds received from these retirement benefits are considered income for Medicaid purposes.

helping prepare medicaid As of 2013, the community based Medicaid recipient is allowed income of $2,841 per month. Income above this amount must be utilized for the Medicaid recipient’s healthcare unless he or she has a spouse with income under $2,841 per month. In this situation, the Medicaid recipient’s income can be utilized by the spouse to bring his or her income up $2,841.