2023 Medicaid Income Limit For Home
Care (Community Medicaid) coverage:
This is a general explaination
- a complete explaination of how the Medicaid program works is provided at a full Medicaid planning consultation.
INCOME LIMIT: Single Person receiving
home care: $1,677 (+$20 exemption) -income over this amount may be placed into a "pooled trust" each month.
Couple both receiving home care: $2,268 (+$20 exemption) - income over this amount may be placed into
a "pooled trust" each month.
*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 $1,677) 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.
2023 Medicaid Income
Limit For Nursing Home Medicaid coverage:
$50 per month.
All surplus income must be given to the nursing home each month, unless there is a well spouse living in the community who
may be allowed to retain a portion of their institutionalized spouses income.
RESOURCE LIMIT: Single person is permitted to retain a maximum of $30,182.00 in total
countable available assets (checking, savings, CD's.... and other non-exempt assets).
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, begining some time in 2024 there will
be a new waiting period imposed on home care applicants if they transfer funds prior to apply for home care services.
*Implementation of the new look-back for home care services has been postponed unitl 2024.
2023 Spousal Allowances
The non-applicant spouse is permitted
to retain the following amounts when their spouse enters a nursing home with Medicaid coverage:
~Well
spouse Income : $3,715.50 per month from their combined income -- if this amount is exceeded, then Medicaid
may request monthly income contributions from the well non- applicant spouse;
~Well
Spouse Resources: Between $74,820 and $148,620 -- if this amount is exceeded,
then Medicaid may seek reimbursement from the well spouse holding the excess funds.
Medicaid Estate Recovery Rights
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 passing.
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:
- Medicare
1-800-MEDICARE
(1-800-633-4227)
TTY users should call 1-877-486-2048
Or
for free personalized health insurance counseling contact:
** Click Here to be taken to the New York State Medicaid Program Website for more public information Medicaid.
