Low-income, low-asset New York residents of all ages may be eligible for Medicaid, the nationwide health insurance program. Federally and state funded, Medicaid covers costs associated with long-term care, including doctors visits and nursing home care. In New York, coverage for long-term care under Medicaid falls under the Managed Long-Term Care Medicaid Plan
In addition to U.S. citizenship and New York State residency, applicants aged 65 and older must earn no more than $10,300 for individuals or $15,200 for couples annually and possess no more than $15,450 (individuals) or $22,800 (couples) in assets. Medicaid considers income from any source when determining eligibility, and in addition to wages, this includes IRA payments, pensions, alimony and Supplemental Security Income. Countable assets include stocks, bonds, bank accounts, vacation homes and properties. However, certain assets are excluded, and these include one car, household goods, burial funds up to $1,500, prepaid funeral arrangements and a principal residence valued at $858,000 or less. If the applicant’s spouse currently resides in the home, it’s considered exempt regardless of value.
Those with yearly incomes over the Medicaid limit may still qualify through the Medicaid Excess Income Program. Eligibility depends on evidence that excess income is spent on medical bills, and over-the-limit amounts are determined by your Medicaid caseworker. To apply for Medicaid or learn more about about the Excess Income Program, contact New York’s Human Resources Administration at (718) 557-1399.
Managed Long-Term Care
The MLT system is designed to help those who require a nursing home level of care but prefer to remain in their homes and communities. The Medicaid plan brings seniors services and supports to their homes or within their communities, including nurses, home health aides and physical therapists; assistance with grocery shopping, dressing and bathing; home-delivered meals; speciality therapies, such as occupational and physical; and transportation to medical appointments. For questions regarding MLT Medicaid, contact New York Medicaid Choice at (888) 401-6582.
Assisted Living Program
ALP provides all the services an assisted living resident would receive. This program is available to Medicaid recipients as well as private payers, but both must be medically eligible for a nursing home level of care in order to qualify. Enrollment is limited, and nearly 85% of beneficiaries receive Medicaid. Those interested can contact the ALP directly, but Medicaid recipients must first have their ALP services approved by New York’s Human Resources Administration.
ALP services include:
- Case managers
- Personal care
- Room and board
- Personal emergency response services
- Physical, occupational and speech therapies
- Medical equipment and supplies
- Home health services
- Nursing
To learn more about ALP, contact the New York State
Department of Health at (800) 342-3720 or (212) 368-4500.