Q: I am 75 years old, receive Social Security Retirement income and a pension, can I qualify for Community Medicaid?
A: The short answer is “maybe.” Medicaid for long-term care for New Yorkers over 65 years old has both income and asset rules for eligibility. To qualify for services, the applicant’s countable assets must be under $31,175 in 2024. Tax-deferred retirement accounts, prepaid irrevocable funeral contracts, and various other types of assets are not counted toward this limit.
If you can show your assets are below the threshold, we look to income. In 2024, the Medicaid gross income limit is $1,752 (including a $20 disregard for being aged, blind or disabled). In addition, you can keep enough income to pay any premiums for health insurance, including Medicare Part B, Medicare Advantage Plans, Medigap Supplemental Plans, or Medicare Part D for drug coverage. Any amounts above this will be deemed to be excess or surplus.
The good news is that for Community Medicaid, which provides care in the home, you will not lose access to your excess income. This is where a pooled income trust comes into play. A pooled income trust is a type of supplemental needs trust that is used to shelter the excess income of a Medicaid recipient so it can be used to pay the expenses beyond those covered by Medicaid. With Social Security Retirement Income and a pension, you may be well over the $1,752 limit. To be eligible for Community Medicaid, you must distribute the overage into the trust. After a small administrative fee is deducted each month to pay the fees of the Trust Administrator, the balance of the income is available for use. This can include rent, mortgage, food, clothing, real estate taxes, certain home repairs, and other day to day expenses.
While the funds in the pooled income trust can accumulate from month to month, any funds remaining in the trust at the death of the Medicaid recipient will be forfeited. For this reason, it is a good idea to spend the money each month to avoid the loss.
A pooled income trust is not a tool used for advanced Medicaid planning, but rather one that is utilized at the time of application. Joining a pooled income trust is an important step of the Community Medicaid application process.
- Britt Burner, Esq.
Britt Burner, Esq. is a Partner at Burner Prudenti Law, P.C. focusing her practice areas on Estate Planning and Elder Law. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.