The NYS Department of Health has issued new Medicaid eligibility thresholds for 2024 based on federal income guidelines. Expanding on the dramatic change in 2023, New Yorkers age 65+ and people with disabilities now benefit from even higher income and asset limits.
Last year, Medicaid eligibility thresholds and standards drastically increased. The income threshold rose from 100% of the federal poverty level (FPL) to 138%, allowing Medicaid applicants to keep more income, as well as lower their spend-down or funding of a pooled income trust (or completely void the need for one if their income is below the new threshold).
Additionally, the asset limit for Medicaid drastically increased; Medicaid buy-in for people with disabilities and other programs increased; and for the first time, undocumented immigrants age 65+ qualified for full Medicaid benefits.
For 2024 the FPL has been adjusted, and with it the threshold amounts for Medicaid eligibility. These have increased, though not as significantly as last year.
INCOME
For 2024, the income limits for both Community and Institutional Medicaid are:
Married (both spouses applying): $2,351/month.
Married (one spouse applying): $1,732/month for the applicant.
Single: $1,732/month.
People with income higher than the 2024 threshold may still be eligible for Medicaid assistance, depending on various factors.
Most income sources count toward the income limits, including salaries, pensions, Social Security Income, Social Security Disability Income, gifts, annuity payments, IRA distributions, and alimony. NYS exceptions include VA Aid and Attendance benefits and Holocaust restitution payments.
For a married applicant in a nursing home, all of the applicant's monthly income must go toward nursing home costs, with the exception of a Personal Needs Allowance ($50/month), Medicare premiums, and in some cases a Needs Allowance for a non-applicant spouse.
ASSESTS
For 2024, the assets limits for both Community and Institutional Medicaid are:
Married (both spouses applying): $42,312.
Married (one spouse applying): $31,175 for the applicant and anywhere between $74,820 and $154,140 for the non-applicant, for institutional and some community-based applicants.
Single: $31,175.
Assets countable toward the asset limit include bank accounts (checking, savings, money market), cash, stocks and bonds, investments, and vacation homes.
Non-countable assets, include the primary residence home, household items, personal belongings, vehicles, life insurance policy with cash value up to $1,500, and pre-paid nonrefundable funeral agreements. In NYS, tax-deferred assets such as IRAs and 401Ks in payout status (meaning the applicant is withdrawing the required minimum distribution) are non-countable assets.
LOOKBACK PERIOD
Important note: a new 30-month lookback for Community Medicaid is set to begin soon, possibly as early as March 31, 2024, though it will likely be delayed until sometime in 2025.
NYS still has a 60-month (5-year) Medicaid lookback period for Institutional (nursing home) Medicaid.
The lookback period begins immediately upon one’s application date, during which Medicaid scrutinizes all asset transfers (including by spouses) to ensure assets weren't gifted to meet Medicaid’s asset limit.
Certain planning tools, like trusts, can help ensure assets are exempt from Medicaid scrutiny. Planning and executing these takes time, so those who intend to or may apply for Medicaid should start the process as soon as possible.
For any questions or assistance, contact us.
