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Do I Qualify for New York Medicaid?

We made this page to help you check if you are eligible for New York Medicaid. We are a law firm that helps people qualify for Medicaid even if they don’t think they meet the below guidelines.

If you are aged over 65 or you are disabled:

Income Limit

Family Size Monthly Income
1 $825
2 $1,209

See the official Medicaid income limit for people aged over 65 or disabled here.

The way income is calculated depends on the Medicaid district. Some districts have specific income disregards where they disregard a part of your income so you can qualify even if your income is above the guidelines.

Our law firm may be able to help you become a part of a pooled income trust, which would exempt your income over the threshold from being considered by Medicaid.

Resource Limit

Family Size Total Resources
1 $14,850
2 $21,750

You can transfer your assets to someone else or better yet, transfer the money into a medicaid trust and qualify for Medicaid. You will qualify on the first of the following month.  If you are going to a nursing home, however, there are asset transfer limits – see below.

There is a homestead exemption, so you still qualify for Medicaid if you own a home with an equity of up to $825,000. A home equity loan or reverse mortgage can be used to reduce equity.

If you are disabled but under the age of 65, you may qualify for a special needs trust, which this law firm can help you set up.

If you are under 65 and not disabled:

Income Limit

Family Size Total Resources
1 $1,387
2 $1,868
3 $2,349

In our chart, we’re using the common 138% Federal Poverty level standard of qualifying for New York Medicaid.

There are some situations where you can have a bigger income and still qualify. For example, a pregnant woman or a baby under 1 year of age can qualify with an income that’s 224% of the federal poverty level (that’s $3747 per month for a family of three). Children age 1-5 can qualify with income that’s 154% of federal poverty level.

On the other hand, there are some situations where you need an even smaller income to qualify, for example if you’re getting Medicare (your income has to be as low as 100% of federal poverty level in order to qualify).

Resource Limit

No resource limit for individuals or families who are under 65 and not disabled

See the official New York Medicaid income and resource level chart here.

If you need a nursing home:

There are extra Medicaid rules and restrictions for people who require nursing home care:

Asset Transfer Limits – Transferring assets to someone else will disqualify you for from Medicaid for about a month for every $12,000 you transfer.

Let’s say you’ve given away $120,000. That will disqualify you from Medicaid for about 10 months.

The idea is to force the people to whom you gave the money to return it to you so that you can pay for the nursing home.

Mandatory spend-down – You must pay all of your income over $50 to the nursing home. There is a work-around for that, however, called a pooled income trust.

You can keep your home – You will be allowed to keep your home. You will need to fill out the correct paperwork showing intent to return home. But be careful to avoid a Medicaid recovery lien on the home – Medicaid will place a lien on the home to recover money after your death. There is a work-around for that too – you can easily avoid a medicaid recovery lien by creating a medicaid trust or doing a qualified transfer.

Spousal refusal – the spouse who remains out of the nursing home can sign a spousal refusal so that they can keep their income and their income will not disqualify their spouse from Medicaid. Medicaid has the right to sue the spouse, but that usually does not happen. Under the new Affordable Care Act rules, some people no longer qualify for a spousal refusal.

Ways to Qualify for Medicaid if You Don’t Meet the Thresholds

Even if you don’t think you meet the above thresholds, there are still tools that New York State authorizes us to use in order to help you qualify for Medicaid. You can browse our website to read more about tools such as a medicaid trusts, special needs trusts, pooled income trusts, life estates, annuities, qualified transfers and gift and loan.

For this article, we’ve presented a simplified version of the rules to make it easier to grasp the basic ideas.  The goal was to make as simple of a guide as possible. The actual rules are more complicated, involve more numbers and depend on your particular situation. So even if you think you qualify, you might not, and vice-versa. We’d be glad to schedule a confidential consultation and explain your eligibility as it applies to you.

Law Offices of Albert Goodwin assists people in qualifying for Medicaid even when they think they don’t. You can give us a call at (212) 233-1233 or (718) 509-9774.