Medicaid Eligibility Plan and Applications

Helping Individuals Determine their Eligibility for Medicaid and Complete the Necessary Paperwork

In a nutshell, both federal and New York state law govern Medicaid. It helps senior citizens afford the high cost of long-term healthcare—most often in nursing homes, at home, or in assisted living facilities.

With all of the benefits of the New York Medicaid Program, the program can still be extremely difficult to navigate and often leaves many applicants with few answers and many more questions. This is due, in part, to the complex state and federal laws that govern the program, as well as the fact that these requirements are changing and evolving on a continuous basis. In cases where applicants make even a small financial mistake, they could receive a denial of coverage, or they could face other significant losses.

Fortunately, you do not need to handle the complex Medicaid application process on your own. The experienced New York senior law attorneys at Goldfarb Abrandt Salzman & Kutzin LLP, are ready and willing to assist you throughout the process. Our knowledgeable legal team can sit down with you during an initial consultation and assist you in determining your eligibility.

Furthermore, our attorneys can be by your side during the entire process, from the initial application consultation up through your final approval. Given our many years of experience in the business, we can help you seamlessly navigate the process and avoid the common challenges and pitfalls.

Overview of Medicaid

Medicaid is a state and federal program that currently provides more than 60 million Americans with the health insurance coverage they need. Without Medicaid, many of these individuals would otherwise be unable to obtain affordable health coverage.

From the beginning, the government created Medicaid with senior citizens in mind. Even individuals who work their entire lives and conscientiously save part of their earnings will inevitably run into a problem in the event they are forced to go to a nursing home or assisted living facility in their old age. Moreover, good-quality, long-term health care is becoming increasingly unaffordable—not to mention the fact that Americans, on average, are living longer.

One purpose of the Medicaid program is to help seniors with limited assets fill in these gaps, providing them with coverage for good long-term care that might not otherwise be available to them. The experienced New York senior law attorneys at Goldfarb Abrandt Salzman & Kutzin LLP, are committed to helping these seniors obtain the benefits they deserve.

Eligibility Requirements for New York Medicaid Benefits

In order for New York seniors to be eligible for Medicaid services, they must meet certain financial eligibility requirements. First of all, an individual must be disabled or 65 years of age or older at the time of application.

There are additional requirements for New York Institutional Medicaid. In order for an individual to be eligible to receive New York Institutional Medicaid benefits, he or she must  be under the appropriate asset limit set by Medicaid. Those limits are currently (2018) as follows:

  • Single person – $15,150
  • Couple (i.e., where both spouses are applying for New York Medicaid) – $22,200

In the event that only one spouse is seeking admission to a facility, the community spouse will be able to retain at least $74,820—or a maximum of one-half of the couple’s joint liquid assets up to a maximum of $123,600. In the event the assets are over $123,600,there may be other rules that apply.

In Medicaid terminology, the “snapshot date” refers to the first day of the month on which one spouse goes to a facility, and the assessment of the couple’s joint liquid assets occurs from this date.

Required Financial Statements

New York Medicaid requires that all applicants furnish financial statements for the past 60 months (that is, five years) prior to the date on which the applicant became eligible for Medicaid services and was institutionalized. Medicaid will then review these financial statements and determine whether the applicant or his or her spouse made any transfers or gifts from some other source during that time period.

If the applicant did make a transfer or gift during this timeframe, New York Medicaid can assess a penalty (that is, a period of time during which the applicant will be ineligible for Medicaid institutional services). This period of time will directly correlate with the total amount of the financial gift that the applicant made.

How a Senior Law Attorney Can Help With the Process

Applications for New York Medicaid can be complex. The experienced elder law attorneys at Goldfarb Abrandt Salzman & Kutzin LLP can help develop a plan for determining your Medicaid eligibility. We can assist you by doing the following:

  • Finding out which of your assets are countable and which are exempt
  • Resolving common issues that arise over the course of the process, including spousal refusal, promissory notes, and the Medicaid spend down process
  • Gathering your past 60 months of financial and bank statements as part of the application process
  • Obtaining the necessary bank verifications regarding withdrawals and deposits
  • Offering you a Medicaid consultation in which we determine the best possible method of moving forward
  • Completing the various parts of the Medicaid application

Talk to a New York Elder Law Attorney Today

If you are new to the New York Medicaid process, you  no doubt have many questions about how the process works. At Goldfarb Abrandt Salzman & Kutzin LLP, our New York elder law attorneys understand the many complexities and nuances associated with Medicaid law at both the state and federal levels. We can help you determine your eligibility for benefits and assist you with every aspect of the application process.

To schedule a free consultation and case evaluation with a New York senior law attorney, please call us at (212) 387-8400, or contact us online today.