2024 Changes to New York Medicaid for Undocumented Immigrants 65+
New York State law changed beginning January 1, 2024 to allow for certain types of lawfully present undocumented immigrants aged 65 or older to be eligible to receive Medicaid. While the law is specific and has certain exemptions, it broadens coverage ability for many undocumented immigrants who would otherwise not have access to health care insurance. Older immigrants should work with an elder law attorney who understands Medicaid spend-down rules so they can plan for retirement and care as they age. 
There are many legitimate reasons why an immigrant may be in the U.S. without permanent resident status, also known as a “green card.” If they meet certain requirements, they are now eligible for full Medicaid in the state of New York.
Understanding New York Expanded Health Care for Undocumented Immigrants
New York now makes available a new health insurance option for undocumented immigrants 65 and older. This law is specifically for undocumented immigrants in New York who meet certain criteria that allow them to be considered “lawfully present.” This expands previous rules which only allowed undocumented immigrant seniors age 65 or older access to temporary, emergency Medicaid. The expanded Medicaid coverage means not only coverage of visits to health care providers such as primary care visits, preventive care and wellness screenings, and lab tests but also coverage for prescription drugs and services such as home care and care in a nursing home.
Financial Qualifications for Medicaid in New York
This is the same coverage other Americans who are 65 and older have access to if they qualify financially for Medicaid. To qualify, you must have income and resources below 138% of the Federal Poverty Line. For example:
- For a one-person household: $20,121 of annual income, with total resources of less than $30,182.
- For a two-person household: $27,124 of annual income, with total resources of less than $40,821.
If you were previously receiving emergency Medicaid, you will be automatically transitioned to the new plan. If you did not previously have any coverage, you may apply through your local Department of Social Services or via the New York City Human Resource Administration.
Spending Down Assets to Help Qualify for Medicaid
Your “estate” is simply a legal term for everything you own: all of your assets, including money in bank accounts and any property you own such as houses and cars. Estate planning means planning for how your assets will be used and disbursed after you are gone.
If your income is above the financial threshold to qualify for Medicaid (“asset limit”), you may be able to divert some of your assets into estate planning instruments that will lower your taxable income. This is often referred to as a Medicaid “spend down” amount—the amount between what you currently make or possess vs. what is needed to qualify for Medicaid.
By diverting some of your assets into estate planning instruments, you can provide for your later health care needs and share assets with your family that would otherwise have to be spent to qualify for Medicaid.
Even if you don’t have an estate plan, an experienced elder law attorney can help manage your assets, save for when you need elder care, and lower your income so you qualify for Medicaid. These steps can include putting assets into a trust, purchasing long-term care insurance, buying annuities, transferring the title on real estate, and making gifts of cash or other assets to family members.
Even if you already financially qualify for Medicaid, immigrants should consult with an elder law attorney to protect the assets they have and designate what happens to those assets after they pass away.
Our New York Estate Planning Lawyers Can Help
Spending down and diverting assets to qualify for Medicaid should be discussed with someone with a deep knowledge of New York State law and an understanding of elder law, immigration status, and Medicaid rules. Work with a trusted estate planning lawyer who has experience helping undocumented immigrants and can help you manage the assets you have to preserve what you can while still qualifying for Medicaid care.