How to Apply for Medicaid in New York
You can apply for Medicaid online by clicking here. You can also submit a paper application, which you can find on the state website (here), or get assistance applying via an attorney.
Medicaid Eligibility Program Overview
Medicaid pays for the cost of Nursing Home care in New York that meets certain financial and health criteria. The average cost of Skilled Nursing Care in New York is $171,276 per year, so securing Medicaid coverage is essential. There are 606 nursing homes in New York, most of which accept Medicaid insurance as a form of payment. Nursing homes in New York are currently 86% occupied, with an average of 97,000 patients currently using the 185,900 available beds.
New York Medicaid Asset Limitations for 2024
Individuals in New York can keep $31,175 when they apply to Medicaid for long-term care. This asset limit only applies to assets that are considered countable. Countable assets include; savings accounts, checking accounts, retirement accounts and a second home. If they are over this amount, they must spend down on care.
It’s important to note that individuals are not allowed to give gifts of any amount for a period of 5 years (60 months) before applying for Medicaid. If an individual’s assets are more than $31,715. Or, if they have multiple assets and are looking to access Medicaid, it may make sense to speak with a Medicaid Planner or Elder Law attorney in New York.
Couples requiring Medicaid for long-term care in New York are allowed to keep $42,312 in assets. If one spouse requires care and one does not, the spouse that does not receive care is known as the Community Spouse. The Community Spouse is allowed to keep 50% of their assets up to $154,140 in countable assets, which is known as the Community Spouse Resource Allowance. The Community Spouse is allowed to keep 100% of their marital assets up to $74,820. If the Community spouse is residing in the couple’s home the house may not be a countable asset.
The maximum amount of home equity allowed when applying to Medicaid is $1,071,000. Despite the fact that the home is not a countable asset, Medicaid can look for repayment in probate court from the sale proceeds after it stops paying for care. It is important to understand if your home may be subject to the Medicaid repayment process.
All of an individual’s monthly income must go towards their cost of care, which can include medical bills, prescriptions and other health care costs. $50 can be set aside for the personal needs allowance. If an individual is married, the spouse’s income does not typically count towards the income cap, but it is important to maximize income protection via the Monthly Needs Allowance rules. The maximum amount of income the Medicaid office allows a community spouse to keep in New York is $3,853.50. The income limits are based on a percentage of the Supplemental Security Income defined by the Social Security Administration’s Federal Poverty Levels (FPL) and change annually.
Penalty Information in New York For Medicaid
If a gift of any amount is given in New York during a period of 5 years before applying to Medicaid, a penalty period will be initiated. This penalty period in New York is called a look-back period, which can make an individual not eligible for Medicaid. Medicaid will not pay for care until the penalty period is over. The penalty is calculated by taking the total amount of any gifts given and dividing it by $12,241 (Varies based on geographic location). The quotient is the number of months which must be paid for privately before Medicaid becomes the payor source.
The average cost of Nursing home care (private room) in New York is $15,257, so penalties can become very costly for a family that has not planned appropriately for Medicaid.
| New York Medicaid Eligibility Information 2024 | Single | Couple |
| 2024 New York Medicaid Income Limits | $1,732 | $2,351 |
| 2024 New York Medicaid Asset Limits | $31,175 | $42,312 |
| 2024 New York Home Equity Limits | $1,071,000 | $1,071,000 |
