Q: Have there been any changes to the eligibility thresholds for Community Medicaid program in 2024?
A: Yes, the amount of income and resources an individual is allowed to have when applying for Community Medicaid has changed. In 2023, a change in law went into effect in New York State which made the threshold amounts 138% of the Federal Poverty Level (FPL). Accordingly, each year as the FPL is adjusted, so are the threshold amounts for Medicaid Eligibility.
For 2024, an individual applying for Community Medicaid can have no more than $31,175 in assets, excluding the home if the equity is less than $1,071,000. Tax-deferred assets, otherwise known as qualified accounts, such as IRAs or 401(K)s, are exempt, so long as the applicant is taking minimum distributions. The amount of the distribution required by Medicaid will vary based on the applicant’s county of residence. Regardless, the full amount of the distribution will be counted towards the monthly income. The 2024 Community Medicaid monthly income allowance is $1,732 per month (plus an additional $20 for being blind, aged, or disabled). However, do not be discouraged from applying from the program if you have excess income as applicants with income that exceeds this limit can still be eligible.
New Yorkers have the benefit of being able to utilize a Pooled Income Trust to hold excess income. This allows them to be eligible for Community Medicaid AND keep the use of their income for other household and personal expenses.
As a further update about the program, there is still no lookback upon application for Community Medicaid. This means that when applying, the county will not search your financial past to find out if assets have been transferred out of your name. In 2020, the New York State budget included a provision that would impose a 30-month lookback for Community Medicaid. To date, this provision has not been implemented. As per the latest information from the New York State Department of Health, the earliest the 30-month look-back period will be implemented, if ever, is mid to late 2025.
The eligibility rules are different for those applying for Chronic Medicaid to cover the cost of long-term care in a nursing facility. Due to the potential complexities of applying for eligibility for Community or Chronic Medicaid, it is imperative to consult with an expert attorney in the field to figure out how these rules effect you or your loved ones who are in need of care.
Britt Burner, Esq. is a partner at Burner Prudenti Law, P.C. focusing her practice areas on Estate Planning, Elder Law and Trusts and Estates. 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.