Medicaid Guideline Updates.
What is Medicaid?
Medicaid is a government funded program, which provides free or low-cost medical insurance for individuals who are eligible. For seniors, Medicaid planning is one of the most important financial decisions to be made. Seniors who require long term care, such as facility or at home care, can easily exhaust the resources accumulated throughout their lives. Even on Medicaid, it is still possible for recipients to keep their home. The potential downside for those who require nursing home care is that Medicaid can attach a lien (a claim for debt) against the property. This would allow for them to pay themselves back for the cost of treatment associated with the nursing home.
Please check our website frequently for additional and updated information about how to best avoid sacrificing the value of your hard-earned assets in order to cover medical costs. Check out one of our newest posts; Benefits and Burdens of the Irrevocable Trust.
Who is Eligible for Medicaid?
In order to determine eligibility, the Medicaid office will measure a person’s assets and income. If an individual or married couple are found to be within the asset and income limits, they can receive Medicaid, eliminating the financial burden of medical costs as we age. If a person falls outside of these boundaries, there remains an opportunity to receive Medicaid benefits, but it requires additional work and maneuvering.
As of January 1, 2023, there have been significant changes to the eligibility requirements for Medicaid. Thanks to Governor Kathy Hochul, and the numerous organizations advocating for these limit increases, more people are eligible for Medicaid than ever before.
In prior years, Medicaid recipients were required to maintain an asset and income limit that simply failed to evolve with our changing economy. As of 2022, the individual asset limit was only $16,800 annually with the couple limit set at $24,600. With Governor Hochul’s new Medicaid overhaul, the Medicaid program now caters to individuals with an asset limit of up to $30,180 annually and a new couple limit set at $40,820.
Income limits have been altered as well. In 2022, an individual making more than $934.00 each month would become ineligible for Medicaid. A couple making $1,367 would similarly find themselves ineligible. As of 2023, the monthly income limit has been increased to $1,677 for individuals and $2,268 for couples. This is a life changing alteration for New Yorkers as we continue to deal with the effects of the COVID-19 pandemic.
What If I Still Have/Make More Than These Limits?
While those who currently possess assets in excess of the limit, or are making too much money each month generally find themselves paying the bill for their medical care, there are still ways to qualify for Medicaid, despite these higher assets or income. One particular method, known as the Medicaid “Pooled Income Trust,” is popular with many recipients. This kind of Trust permits a person who would normally be disqualified from Medicaid benefits to place the excess portion of their assets or income aside for the purposes of determining eligibility. The assets or income are placed into this Trust, for use on behalf of the Medicaid Applicant. The assets and income are used to fund an Applicant’s needs such as rent, groceries, utilities, and even funeral planning. With the excess funds being placed aside, the person is no longer disqualified and only a portion of their overall assets and income must be applied to the Trust.
What if I Already Have a Pooled Income Trust?
If you already have this kind of Trust established, it may be time to request a renewal. Individuals already benefitting from a Pooled Income Trust may be able to discontinue their payments into this program entirely, thanks to the asset and income limit increases. With these increases there are many Medicaid recipients who will no longer require a Pooled Income Trust, and will now be under the limits. This means that, after a renewal, the recipient would be able to keep more or even all of their monthly money.
How Can I Renew to Take Advantage of These Changes?
In order to benefit from the increase in the Medicaid limits, a recipient will have to complete their renewal process. This process will begin in March and April of 2023, with renewal packages to be mailed to every recipient throughout the next twelve months. Once a person receives their package, they will be applying the new income and asset limits for 2023 (see Eligibility, above). For persons who require a more urgent change in their circumstances, they can call Medicaid directly to request that their case receive a renewal earlier than the mailed-out packages. For those recipients who are scheduled to receive their renewal packages later in the twelve-month cycle, it is all the more important that the renewal request be made to ensure that the recipient is not required to pay into a Pooled Income Trust or to “spend down” any of their assets or income.
Contact our office to schedule a consultation today.
