Medicaid Planning

New York Medicaid is a joint Federal and State program. Unlike Medicare, this program has resource and income eligibility standards. Medicaid covers Long Term Care ("custodial care") which is not covered under Medicare or Medicare Supplemental Insurance.

You can qualify for Medicaid if you are aged 65 or older, blind or disabled individuals, or children under age 21 who meet the income and resource Medicaid eligibility requirements may qualify for Medicaid. Others may qualify by meeting the public assistance standards of eligibility.

Eligibility for Medicaid Applicants

The Medicaid applicant is allowed to have non-exempt assets up to $3,600 (for 2000, adjusted annually). Funeral expenses may be prepaid.

A primary residence is exempt for purposes of Medicaid eligibility under certain conditions.

Irrevocable Living Trusts can be created so that the assets will not be considered available for purposes of Medicaid eligibility subject to the transfer penalty rules. In addition, there are Special Trusts which can be set up for a disabled individual without a transfer penalty.

There is a thirty-six (36) month look back period for purposes of Medicaid eligibility. A sixty (60) month look back period applies in regard to transfer to and from certain types of Trusts.

There is a period of ineligibility for nursing home care under Medicaid for the transfer of assets for less than full consideration, subject to certain exceptions.

A community spouse will be able to retain a certain level of resources and monthly income, and, at the same time, have an ill spouse qualify for nursing home care under Medicaid.

The Medicaid recipient's monthly income over a certain level must be used to pay for care, before Medicaid will pay the unpaid balance.

There are three primary programs under Medicaid:

• The Community Based Home Care Program which provides care at home;
• The Nursing Home Care Program which provides care in a nursing home; and
• The Long Term Home Health Care Program which provides a coordinated plan of health care and social services for an individual at home.