Medicaid is a state- and federally-funded program that provides critical long-term health care benefits to low-income families, disabled adults, and some senior citizens.
While New York exempts most Medicaid recipients from “means tests”—a method to determine whether a person qualifies for financial assistance—the state Department of Health does consider income and assets when determining eligibility, our Brooklyn Medicaid planning attorney adds. Retirees and other senior citizens ages 65 or over, for instance, may not qualify for Medicaid if they own real property, maintain a well-funded investment account, or retain any significant savings.
However, New York families do not necessarily have to forfeit their taxpayer-funded Medicaid entitlements simply because they managed to save enough money for retirement.
An Overview of New York Medicaid Terms
Medicaid is an essential program that provides health insurance and other coverage to an estimated eight million New Yorkers—well over one-third of the Empire State’s overall population.
However, Medicaid officials often explain benefits and adjudicate claims with reference to complex terminologies. These terminologies can make Medicaid planning difficult, even for families who have experience navigating New York’s legal system.
Before you begin planning to preserve your Medicaid benefits, you may need to familiarize yourself with Medicaid terms.
A community spouse—sometimes referred to as a “well spouse” or “non-applicant spouse”—is the spouse of a New York resident receiving Medicaid benefits in a long-term care setting, such as a nursing home.
However, Medicaid beneficiary can only be classified as community spouse if they are living independently, whether in their own home or an assisted living facility.
An institutionalized spouse is the spouse applying for long-term Medicaid benefits.
However, institutionalized spouses do not necessarily have to reside in an institution. They can, instead, receive other long-term services through a Medicaid waiver program.
Spousal Impoverishment Law
Since New York nursing homes often charge thousands of dollars per month, Medicaid introduced a “spousal impoverishment” rule that lets the community spouse—the spouse living at home—retain a reasonable share of the married couple’s combined assets.
Minimum Monthly Maintenance Needs Allowance
The Minimum Monthly Maintenance Needs Allowance (MMMNA) is a subset of the spousal impoverishment rule. Under the MMMNA, a community spouse with little to no monthly income sets a minimum monthly income limit. This limit does not count toward or affect either spouse’s Medicaid eligibility. The MMMNA in most states, including New York, is $2,465. The maximum limit is $3,715.50.
Countable assets include most liquid assets that can be converted to cash and used to pay for long-term care.
Some assets are considered exempt assets or assets that cannot be used in Medicaid eligibility calculations. Exempt assets include the applicant’s primary place of residence, personal effects, and certain insurance policies.
The Importance of Medicaid Planning
New York’s Medicaid system enacts and enforces strict criteria for eligibility. Families, including retirees, may not be able to receive critical benefits if their retirement income exceeds the maximum monthly allowance.
If families are ineligible for Medicaid, they may be forced to pay for long-term care out of pocket. In New York City and in Long Island, the annual costs of nursing home accommodation and care average is over $124,000 per year. Even for retirees with significant savings, the high costs of care can prove prohibitive, forcing senior citizens to choose between their physical well-being and their financial stability.
Medicaid planning provides New Yorkers with an opportunity to receive government-subsidized care while still retaining their assets.
Medicaid Planning Strategies
The experienced Brooklyn Medicare planning attorneys at Alatsas Law Firm can help protect your hard-earned assets while preserving your eligibility for subsidized care by implementing strategies that include: