New York Medicaid Eligibility in 2025

Q: How does one qualify for New York State Community Medicaid to receive care services in their home? A: Each year, there are slight adjustments to the financial eligibility requirements of community Medicaid for adults receiving the assistance of a home health aide. By law, the allowable income and asset limits are set at 138% of the Federal Poverty Level. In 2025, an applicant must have less than $32,396 in countable assets and less than $1,800 in countable income. However, individuals with income or assets higher than this are not necessarily locked out of the program. Countable assets can include bank accounts, cash value of life insurance, brokerage accounts, and non-qualified annuities, to name a few. Importantly, qualified funds such as a Traditional IRA, 403(b), and other tax deferred monies are not considered as long as they are in "payout status." For those with countable assets above the limit, New York does not currently impose a lookback period for the homecare program. This means that an applicant can transfer excess assets to a family member, friend, or Medicaid Asset Protection Trust and be eligible to apply in the following month. With income including, but not limited to, Social Security payments, pension, and distributions from a tax deferred retirement account, many adults in need will have excess income that is enough to cover their day-to-day expenses but not sufficient to pay for care needs. Good news… even with income that is over the limit, a pooled income trust ("PIT") can be used to shelter the excess. A PIT is a type of supplemental needs trust that is administered by an organization with an underlying charitable cause. The excess is moved into the PIT each month and then made available to the Medicaid recipient to pay expenses for their own benefit such as rent, mortgage, utilities, food, clothing, etc. Any unused funds will accumulate in the trust from month to month and can be used into the future until the time of death. Even though there is currently no lookback imposed in New York for Community Medicaid applicants, advance planning is advisable. Protection of the home and other assets should be top of mind for those that may be seeking this type of care now or in the future. - Britt Burner, Esq. Britt Burner, Esq, is an attorney at Burner Prudenti Law, P.C., focusing her practice on Elder Law and Estate Planning. Burner Prudenti Law serves clients from Manhattan to the east end of Long Island with offices located in East Setauket, Westhampton Beach, New York City and East Hampton.

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New York Medicaid Eligibility in 2025