How to Stay at home and protect your assets and income
In New York, the Community Based Medicaid program will pay for the cost of a home health aide. When applying, the local department of social services considered the applicant’s income and assets and whether the Medicaid applicant requires the assistance with the activities of daily living. The following is a breakdown of how DSS evaluates each for a New York Community Medicaid application.
Activities of Daily Living
An individual over the age of 65 is considered “disabled” and therefore entitled to Community Medicaid benefits if they need assistance with the activities of daily living, These include bathing, dressing, toileting and feeding. For most that are interested in Community Medicaid, this is not a difficult a difficult threshold to reach. Any applicant with the onset of dementia or Alzheimer’s or with physical disabilities that limit their ability to live on their own, is sufficiently “disabled” enough to receive Community Medicaid benefits.
Income is calculated by adding the following: Social Security, Pensions, income from rental properties or other investments, and require maximum distributions from retirement accounts. Under Community Medicaid rules in New York, the Medicaid recipient is entitled to keep $825 per month of their income (for a single person). The remainder of the recipient’s income is called a “spend down” “excess income” or the “surplus”. Most of those who can stay at home will have expenses far exceeding the $825 limit. Medicaid understands this and allows for an exception. The often used exception is called a “Pooled Income Trust”.
For Medicaid purposes in New York, assets include any real property owned by the applicant or savings in the form of money markets, CD’s, stocks, bonds, cash values in insurance policies, and other non-retirement investments. When applying for Community Medicaid in New York, the applicant’s total assets must be under $14,850. Clearly, most individuals in New York City, Queens, Brooklyn, and Long Island, are worth more than $14,850.
Many have heard of a five-year look-back period on asset transfers when applying for Medicaid. It is true that a five-year look back period exists – but only for Institutional Medicaid application where the applicant is residing in a nursing home. When applying for Community Based Medicaid applications in New York, there is no five-year look back.