New York recently changed eligibility standards for New Yorkers who are disabled, 65+ or blind.

The income limit will increase to 138% of the Federal Poverty Line (FPL), which is the same limit used to calculate the Modified Adjusted Gross Income (MAGI) for individuals under 65 who do not have Medicare. The income level will increase to $1,563 per month for a single person and to $2,106 per month for a couple (increased from the previous limits of $934 and $1,367, respectively). Despite the increased limits, Medicaid applicants can still spend down excess income on medical bills or through the use of Pooled Income Trusts.

Be aware that certain types of income, including Veterans’ benefits, Workmens’ Compensation and gifts or inheritances, are excluded from MAGI Medicaid but included for non-MAGI Medicaid. However, spend-down tools such as pooled income trusts and spousal refusal, are still available for non-MAGI Medicaid.

The resource limit will also increase in 2023 to $28,133 for a single person and to $37,902 for a couple (increased from the previous limits of $16,800 and $24,600 respectively). This allows applicants to maintain eligibility while retaining significantly more assets.

New applications for Medicaid will be assessed under the new limits. However, existing Medicaid recipients with a spend-down will want it reduced under the new limits. There will be two options: (i) wait until the Medicaid renewal (currently on hold due to the Public Health Emergency) or (ii) ask the local Medicaid agency to rebudget the spend-down. Current recipients who have been depositing income into a Pooled Income Trust may be able to reduce their contribution to the trust or may be able stop the use of the Pooled Income Trust completely. 

The increases are based on the 2022 FPL and subject to change once the 2023 FPL is released. As such, any changes to spend-down should be calculated conservatively until final figures are available.

In addition to the income and resource limit changes, undocumented immigrants age 65+ will be eligible for Medicaid.

For more information, contact Julie L. Cross, Esq. at jlc@spsk.com or 201-262-3962.

DISCLAIMER:  This Alert is designed to keep you aware of recent developments in the law. It is not intended to be legal advice, which can only be given after the attorney understands the facts of a particular matter and the goals of the client.