Eligibility Guidelines For Medicaid Home Care and Nursing Home

Medicaid eligibility changes, effective January 1, 2023!

Posted by on 2nd Jan 2023

Effective January 1 2023, most New York Medicaid recipients will be able to keep more of their assets and income. These new rules apply to those receiving Medicaid benefits for home care as well as nursing home services.

As many people are aware, in order to be eligible to receive home care or nursing home Medicaid benefits the applicant must have below a certain amount of countable assets in their name. For 2023, that countable asset limit is increasing from $16,800 to $28,133 for an individual applicant, and from $24,600 to $37,902 for a married couple both applying. This new increased asset limit will allow Medicaid recipients to keep more in their names while still being eligible for benefits.

On the income side, the 2023 monthly income limits for home care Medicaid is increasing from $934 to $1,563 for an individual applicant, and from $1,367 to $2,106 for a married couple both applying. This income limit increase will provide more breathing room: 1) less people will need to utilize pooled income trusts to protect their excess income if their income is less than the new increased limit, and 2) Those who still need a pooled income trust can keep more of their income in their names. However, the income limit for recipients of nursing home Medicaid benefits will not change, remaining at $50 per month.

Overall, these increased asset limits are a favorable change and will provide many Medicaid recipients and their families with increased flexibility. Those already receiving Medicaid home care benefits can request a revised income budget reflecting the new limits. You can either contact your local (county) social services department, provide them with your current gross income and allowable deductions, and request a revised income budget, or have a professional do this for you. Notices to this effect have been sent out by the department of social services.

The rules determining Medicaid eligibility, including asset and income rules, can be complicated. There are numerous exceptions, tax and non-tax considerations, and special rules that exist. If you or a loved are considering applying for Medicaid benefits and want to know how you may become eligible, I can assist in the application process, guide you through the process and be the helping hand you may need.