Medicaid Sign and a StethoscopeWhen applying for Medicaid benefits, there are certain income limits that you need to be aware of. Many people are dismayed to learn that they earn too much money—or have access to too many resources—to be eligible for state-sponsored nursing home benefits. Fortunately, changes to state law are bringing Medicaid access to more New Yorkers than ever before.

As of January 1, 2023, New York State will expand Medicaid to cover more residents who are blind, disabled, or over age 65. While the expansion brings many beneficial changes to Medicaid rules this year, applicants may still need the help of a Medicaid planning attorney if their assets are higher than allowable limits. Understanding how these limits work and what it means for your application is essential.

Medicaid Applicants Have Higher Income and Resource Limits in 2023

Increasing state Medicaid income and resource limits allow thousands more people in New York to qualify for home care services or long-term care benefits. In the past, some recipients lost their Medicaid benefits when they were approved for Medicare benefits due to conflicting eligibility requirements. Part of the 2023 expansion equalizes income limits across Medicaid recipients regardless of age or whether they have Medicare.

If you’re applying for Medicaid long-term care benefits in 2023, there are some other changes that could affect your eligibility, including:

  • Spend-down suspension. Depending on demographics, Medicaid recipients may not have to spend down to be eligible for benefits—or they could be required to spend much less of their excess income.
  • Increased income limit. The New York State income eligibility criteria set the maximum earnings to 138% of the Federal Poverty Level (FPL). Individuals applying for Medicaid can earn $1677 per month ($20,121 per year), and couples can earn $2268 per month ($27,214 per year) without risking their benefits.
  • More allowable resources. The resource limit for Medicaid recipients is also being raised to $28,133 for an individual and $37,902 for a couple, an increase of more than ten thousand dollars in assets over the previous year.
  • Increased resource limits for specialized programs. The state has also raised resource limits for the Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD), allowing $28,133 for an individual and $37,902 for a couple.
  • Restructuring the Medicare Savings Program (MSP). Improvements to this state-run initiative that pays Medicare-related costs (such as Part B premiums) will be split into two groups: Qualified Medicare Beneficiary (QMB) and Qualifying Individuals (QI). The QMB program pays for the recipient’s Part B premium as well as coverage for all co-pays, coinsurance, and deductibles—more significant savings to recipients than the now-defunct Specified Low-Income Medicare Beneficiary (SLMB).
  • Greater income limits for Medicare savings. The income eligibility limit for QMB has been raised to $1,563 for an individual and $2,106 for a couple, while the QI income limit has been raised to $2,107 for an individual and $2,839 for a couple. Maximum income levels for these programs will likely increase again later in the year.

How Do These Changes Affect My Medicaid Benefits?

If you are already receiving Medicaid benefits, the Department of Health should have sent you a letter informing you on whether you’re still required to spend down your income. If you are not currently a Medicaid recipient but are considering applying, our legal team can determine your eligibility and help you complete and submit your Medicaid application.

If you have a spend down and your income is over the new limit, we can help you set up a trust and explore creative ways to preserve your estate while getting you the benefits you need for long-term care.

The Medicaid planning attorneys at Landskind and Ricaforte Law Group, P.C. combine benefit eligibility with careful estate planning, ensuring that your family is provided for while you get the care you need. Contact us today through our online form to get started or read our free book, Estate and Medicaid Planning in New York: What Everyone Needs to Know.


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