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Substantial increase in Medicaid eligibility levels in January 2023

by | Jan 25, 2023 | Medicaid Planning |

New York Medicaid asset and income limits for Long Term Care Medicaid are based on a percentage of the Federal Poverty Levels (“FPL”).  On January 1, 2023, New York State will increase these percentages.  This translates into substantial increases for both income and asset limits for current Medicaid recipients in New York State.

The figures below are based on the 2022 FPL and will likely be updated in February or March 2023 when the amended poverty level is released.

Asset Limits for Community and Chronic Medicaid:

  • Individual: $28,133 (increased from $16,800)
  • Couple: $37,902 (increased from $24,600)

Income Limits for Community Medicaid:

  • Individual: $1,563 (increased from $934)
  • Couple: $2,106 (increased from $1,367)

All current Community Medicaid recipients are set to receive a letter explaining the income limit increase.  Recipients may choose to contact their local Medicaid agency to request an income recalculation which may eliminate or reduce his/her monthly spenddown.  If the recipient does not contact the local agency, the budget will be recalculated at annual renewal.

For Chronic Nursing Home Medicaid applicants, the Department of Social Services imposes a penalty for any transfers of assets during the immediate five years prior to the application.  The 2023 penalty divisor for Nassau and Suffolk has increased to $14,136.  This means that for every $14,136 of gifts within the five-year lookback, the Applicant will be ineligible for one month of Medicaid covered nursing home care and will be obligated to privately pay.

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