New York Medicaid Recipients Who Had Coverage Terminated on March 6, 2018, May Qualify for Restored Coverage

by David Goldfarb

Previously, we had advised that Medicaid applicants or recipients must apply for Medicare if they are ages 64 and nine months, and have income at or below 120 percent of the Federal Poverty Level (or income at or below set state requirements for Medicaid eligibility). Between November 2017 and February 2018, about 30,000 New York Medicaid recipients ages 65 and older received notices threatening the termination of their Medicaid coverage if they did not provide proof of Medicare enrollment by February 7, 2018. This left 2,204 Medicaid recipients without Medicaid coverage on March 6, 2018. After the threat of litigation from Legal Services NYC, the Department of Health has restored coverage to these people.

The state of New York Medicaid coverage remains uncertain. Many more recipients are scheduled for notice in the near future. The experienced elder law attorneys at Goldfarb Abrandt Salzman & Kutzin can help New York Medicaid recipients confirm their eligibility, and help prevent unnecessary disruptions to their coverage.

What Is Happening at the New York State Department of Health?

Like all states, New York maintains its own Medicaid program to provide healthcare insurance coverage to low-income and elderly residents. These programs are funded jointly by the federal government and the states in which they operate. Because of this, most states attempt to reduce their Medicaid costs by requiring eligible subscribers to enroll for Medicare coverage as well.

The Western New York Law Center reports that notices were sent to Medicare-eligible New York Medicaid recipients. Those who were (1) ages 65 or older, (2) were U.S. citizens or permanent aliens for five years or longer, and (3) had incomes less than the Specified Low Income Medicare Beneficiary level (which is currently 120 percent of the federal poverty level) were all advised that they had to provide proof of Medicare enrollment or lose Medicaid coverage.

The threat of litigation restored coverage to Medicaid beneficiaries whom Medicaid dropped by default when they failed to produce proof of Medicare enrollment in time.

This does not, however, mean that Medicaid will never require them to provide proof of enrollment. Furthermore, the New York State Department of Health is preparing to notify another 12,000 Medicaid recipients about the requirement. The Department is working to improve communications and notification to particularly vulnerable Medicaid recipients (such as the elderly, the disabled, and those with limited proficiency in the English language).

Ultimately, however, all eligible Medicaid recipients in New York who are also Medicare eligible, must provide proof of Medicare enrollment. An experienced elder law attorney can help beneficiaries determine whether they are eligible for Medicare—and ensure they get all of the benefits to which they are entitled.

Protect Your Medical Coverage With the Counsel of a New York Elder Law Attorney

Don’t leave your healthcare to chance. Consult an attorney to ensure that you receive all of the benefits available to you, your claims are not denied, and you have the full extent of coverage to which you are entitled. The elder law attorneys at Goldfarb Abrandt Salzman & Kutzin have decades of experience in ensuring that benefits are made available to those who deserve them. Call (212) 387-8400 today to schedule your consultation.