2015 Medicaid Income Limit For Home Care
Single Person receiving home care: $825 (+$20 exemption)
both receiving home care: $1,209 (+$20 exemption)
*Individuals who exceed
these limits may be eligible under the Surplus Income Program (giving it to Medicaid). Surplus income (over $825) is
contributed to the cost of care, unless a 'Pooled Income Trust" is established. A "Pooled Income Trust"
can shelter income so that it may be used for expenses not covered by the Medicaid program.
**NEW Married person option - if married and only one is applying for Medicaid
home care - couple may be permitted to keep up to $3,312 of their combined income each month (this will require
an analysis of the couples monthly income).
2015 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.
2015 Medicaid Resource Limit
For Home Care
Single Person: $14,850
both on Medicaid home care: $21,750
**New Limit for
well spouse - well non-applicant spouse may be permitted to keep $74,820 (protected from Medicaid claim) - this will
require an analysis of the couples total assets.
- Pre-paid funeral (no limit on value) is exempt: must be in a special contract with the funeral home;
- Car and Personal Effects are exempt;
- Home remains exempt as long as the applicant or
their spouse contine to reside in the home (max. home value of $814,000) *(must be your primary residence).
*While exempt for eligibility purposes, a home may be subject to claims or liens by Medicaid, unless proper
planning is put in place prior to the death of the Medicaid recipient.
** Note: Placing your
home in a "Living Revocable Trusts" will not prevent Medicaid from placing a lien on the home should a person
need to receive nursing home Medicaid coverage.
- Retirement Accounts (IRA-401K) of the applicant
and the applicant's spouse. The applicant's retirement accounts must all be paying out the minimum allowable distribution. (note:
income from these accounts is not exempt and will be considered countable income)
Certain income is not counted for eligibility purposes.
- Restitution payments from Nazi persecution
- Income diverted into an approved "Pooled
Income Trust" (home care only)
Transfer Penalties for gifting your assets
apply to nursing home care only
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 Medicaid eligible
the next month.
2015 Spousal Allowances
The non-applicant spouse is permitted to retain the following amounts when their spouse enters a nursing home with
Well spouse Income : $2,980.50 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 $119,220 (approximate - maximum) --
if this amount is exceeded, then Medicaid may seek reimbursement from the well spouse holding the money.
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 try not to leave any assets in the applicant's name that
might go through probate upon their passing.
Pharmacy Coverage Under
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.
information, click on or call:
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