Upcoming Changes to Community Medicaid in New York: What You Should Know and How to Prepare

Enacted in April of 2020, the New York State budget set into motion significant changes to the state’s Medicaid program. Of greatest importance in these changes are a new “look back” as well as new requirements to qualify for Medicaid personal care services.

To this point, the aforementioned changes have not actually been enacted. This was due to the ongoing Covid-19 pandemic. However, New York State does still plan on enacting the changes outlined in the budget.

What Kind of Changes are Coming to New York State’s Medicaid Program?

As referenced above, one of the most significant changes coming to New York State’s Medicaid program is a 30 month “look back”. This “look back” is a review of any gifts or transfer of assets for a 30 month period prior to applying for Medicaid. The current plan is to enact this “look back” on March 31, 2024.

What Exactly is the “Look Back”?

While not subject to review currently, if and when the “look back” is exacted, those applying for Medicaid will be subject to a review of the financial records of both themselves and their spouse for a period of 30 months prior to applying for Medicaid.

If the applicant has any “uncompensated transfers” – including gifts, transfers to family members or transfers to a trust, the applicant will face a penalty period. This penalty period can vary based on the specific individual’s situation.

When Will These Changes Occur?

As mentioned above, the Covid-19 pandemic had a significant impact in delaying the implementation of the planned changes to New York State’s Medicaid program. Some changes will be enacted soon, while other changes are currently set to be enacted on March 31, 2024.

When Does the “Look Back” Start?

The “look back” will only review transfers of assets on or after October 1, 2020. Individuals who transferred assets prior to that date are not subject to the prior mentioned penalty period.

What Other Changes Are Coming to New York State’s Medicaid Program?

The above are not the only changes coming to New York State’s Medicaid program. Set to go into effect January 1, 2023 are new Medicaid income limits.

As the system currently exists, a single individual applying for Community Medicaid is allowed to earn $934. A married couple is allowed to earn $1,367 in monthly income without that income having an effect on Medicaid benefits.

However, these financial figures will rise with the turn of the new year. When the calendar turns, the limits will rise to $1,563 for an individual and $2,106 for a couple.

Figures will also rise for the permitted resource limit for applicants. To meet the current eligibility requirements for Medicaid, a single person’s non-exempt resources cannot be greater than $16,800. This number is currently $24,600 for couples.

Effective as of the new year, a single person’s resources cannot exceed $28,134, while a couple’s income cannot exceed $37,908.

How Can You Plan Ahead for the Changes to the Medicaid System?

For those in need of Community Medicaid services, the best action is to move promptly to prepare and submit their application. By doing so, you can avoid being subject to the changes upcoming. On the other hand, if you will find yourself subject to the upcoming changes to the Medicaid system, it is never too early to prepare. Contact us today to find out how our experienced team of elder law attorneys can assist you.

For more information on various elder law and estate planning matters, read our previous blog articles here.

Image by mohamed Hassan from Pixabay

About the Author

Alyssa Marie Monteleon, Esq.

Alyssa Marie Monteleon is an elder law and estate planning attorney at the Monteleon Law Group, PLLC with offices in New York and Virginia. For more information, please visit www.monteleonlaw.com or call (914) 840-2529.

You may also like these