2021 Medicaid Income Limit For Home
This is a general explaination - a complete explaination of
how the Medicaid program works is provided at a full Medicaid planning consultation.
Single Person receiving home care: $884 (+$20 exemption)
both receiving home care: $1,300 (+$20 exemption)
*Individuals who exceed
these limits may be eligible under the Surplus Income Program (giving their surplus monthly income it to Medicaid like a monthly
co-pay). Surplus income (income over $884) must be contributed to the cost of care, unless the surplus income is placed
into a 'Pooled Income Trust". A "Pooled Income Trust" can shelter income so that it may be used for expenses
not covered by the Medicaid program.
Medicaid Income Limit For Nursing Home
$50 per month.
All surplus income must be given to the nursing home, unless there is a well spouse living in the community who may be allowed
to retain a portion of their institutionalized spouses income.
Transfer Penalty Rules
Currently there are only transfer penalties imposed for nursing home coverage, there are no penalties
for community home care services . Therefore, you may transfer your assets this month and become eligible for community
home care services the next month. However, after October 1, 2020 there will be a new eligibility waiting period imposed on home care applicants. *Implementation
of the new look-back for home care services has been postponed unitl April 2021.
2021 Spousal Allowances
The non-applicant spouse is permitted
to retain the following amounts when their spouse enters a nursing home with Medicaid coverage:
spouse Income : $3,259.50 per month from their combined income -- if this amount is exceeded, then Medicaid
may request monthly income contributions from the well spouse;
Well Spouse Resources: Between
$74,820 and $130,380 -- if this amount is exceeded, then Medicaid may seek reimbursement
from the well spouse holding the money.
Medicaid Estate Recovery
Medicaid always retains the right to seek repayment for all services rendered
to a Medicaid applicant from their probate estate; they may also seek reimbursement from a legally responsible relative (spouse).
Therefore, it is important to avoid leaving any assets in the applicant's name that might go through probate upon their
Pharmacy Coverage Under Medicaid
Once on Medicaid, all pharmacy coverage will be handled by "Medicare Part D". Medicare Part D is
a prescription drug benefit available to everyone with Medicare. It has special importance to people with Medicare and
New York State Medicaid because Medicare Part D replaces Medicaid in paying for most of your prescription drugs.
Under the Medicare Part D prescription benefit almost all of your drugs costs will be paid for by Medicare
instead of Medicaid. You will get prescription drug coverage from Medicare and pay a small Medicare
copayment for each prescription. If you currently receive NYS Medicaid and you do not join a Medicare prescription drug plan,
you may lose all your NYS Medicaid benefits.
When you become eligible for both Medicare and Medicaid
you will automatically be assigned to a Medicare Prescription Drug Plan to make sure you don't miss a day of coverage. You
can also enroll in a plan of your own choosing that may better meet your prescription drug needs. Information about available
plans and the “Medicare & You” handbook is available from Medicare. Be sure to read this information to understand
all the changes.
For more information, click on or call:
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