If you are disabled or elderly, it can be difficult to manage your personal and medical needs on your own, but it’s likely you’re not interested in being taken care of in a nursing home. If you qualify for Medicaid in New York, there are programs for home health care that are paid for by Medicaid that can help you live a quality life in your own home.

Eligibility Requirements for Medicaid in New York

Medicaid is funded jointly by the federal and state governments to provide individuals with support when they can’t afford medical care, including doctor visits, hospitalizations, home care, and long-term care in nursing homes. While the eligibility requirements are basically the same throughout the country, the specific guidelines are set by each state.

Home health care and Medicaid

Medicaid eligibility is complicated and is based primarily on a person meeting income and asset limits. Funds from all sources are considered as part of a person’s income for Medicaid purposes, and they can include pensions, social security, gifts, and payments from annuities and IRAs. In 2019, the monthly income limit for seniors, the disabled, and blind individuals to qualify for Medicaid are:

  • For a single person, $859 in net income per month
  • For a married couple with both spouses applying for Medicaid, $1,267 per month in net income

Additionally, to be eligible for Medicaid, a person can’t have assets that exceed the program’s asset limit. Assets include bank accounts, cash, investments, and vacation homes. Other property, such as a home, car, and personal property, are often excluded when determining the value of someone’s assets. In 2019, a single person could have $15,450 and a married couple $22,800 in total assets.

If an individual’s income and/or assets exceed the Medicaid limits, he may have to spend them down and pay for home health care out of pocket before qualifying for Medicaid, or transfer those assets to a Medicaid trust. It is never too late to plan or save the assets.

Home Health Care Programs Paid for Through Medicaid in New York

If you qualify for Medicaid, you may be eligible for a variety of home health care services. Skilled nursing, therapy sessions, a health aide to help with bathing and medications, and a personal care aide to assist with cleaning and meal preparation are services that can be provided at your home. Here are some programs that can help:

  • PACE and MLTC. If you are a participant of the Program for All-Inclusive Care (PACE) or Managed Long-Term Care (MLTC), you can receive assistance from a skilled nurse, home health aide, and personal care aide in your home. Your doctor or care coordinator must authorize these programs for you.
  • PCSP. The Personal Care Services Program (PCSP) assists Medicaid recipients with personal needs such as bathing, preparing meals, using the bathroom, and housekeeping. Your physician must send in a doctor’s order for the program, and a nurse assessor will visit you in your home to determine your eligibility.
  • CDPAP. The Consumer Directed Personal Assistance Program (CDPAP) offers similar services as PACE and MLTC. It also requires a physician’s authorization and an assessment by a nurse assessor. However, if you are eligible under this program, you can select, train, and fire your service providers.
  • LTHHCP. The goal of the Long-Term Home Health Care Program (LTHHCP) is to keep individuals who would otherwise need to go to a nursing home in their own homes. The program offers a wide range of services coordinated by a registered nurse. To qualify, you must need a level of care provided by a nursing home.

Let Us Help With Your Medicaid Eligibility Concerns

If you have questions about your eligibility for home health care under Medicaid in New York or need help completing your application, contact Landskind & Ricaforte Law Group, P.C. Our experienced elder law & Medicaid attorneys are here to answer your questions and give you the personalized legal assistance you need. We represent clients in Brooklyn, Staten Island, Queens, Manhattan, and Long Island. Call us today to learn how we can assist you.