week, the New York Times reported that over 350,000 New Yorkers have
obtained health care coverage with private insurers on the New York exchange.
The Times mentioned Metroplus, an extremely popular plan, which is run
by the New York City hospital system. For more information on the various types
of health care insurance packages available though Metroplus, visit its website
Of course, as was
expected, Medicaid enrollments have increased and, in all likelihood, will
continue to do so as enrollment deadlines do not apply to Medicaid.
Expanded Medicaid Enrollments and Eligibility
As we have more and more Medicaid enrollees, and even more are expected to
join the rolls in the short term, let’s look at Medicaid eligibility with
respect to assets, that is, both income and resources. When evaluating an
application, Medicaid examines the applicant’s income (money received from a
wide variety of sources, on a monthly or quarterly basis, such as pensions or
IRA distributions) and resources (property both real and personal, such as a
home or bank account) in the possession of the applicant at the time the
application is submitted.
Medicaid views assets as either exempt or
non-exempt, be they income or resources. Exempt assets are excluded when
evaluating an applicant’s eligibility, and non-exempt assets are considered.
Exempt resources include the homestead, and the personal property therein, an
automobile, funeral and burial accounts, war reparations and $14,550.00 in cash
or the like. Be aware that any monies received as a result of war reparations
must be kept separate and apart from other resources. Commingling will cause the
war reparations to be considered non-exempt and will affect eligibility.
Monthly income of
$809.00 is considered exempt. Any income received in excess of that amount will
trigger a spend-down or total denial, depending on the amount with respect to
the applicant’s medical expenses. Certain income is considered temporarily
exempt, such as tax refunds, retroactive Social Security retirement or
disability payments, earned income credit payments or Crime Victim’s Assistance
fund payments. Those sources of income are exempt in the month received and
continue to be considered exempt resources for nine months thereafter.
If, after that time period, the Medicaid recipient still possesses those monies,
then that resource will be considered non-exempt and will affect eligibility.
Reverse mortgage payments are considered exempt in the month received but become
non-exempt in the following month, the idea being that one receives reverse
mortgage payments to help with monthly expenses and not as a savings tool, like
What if Medicaid makes a determination that income or
resources are no longer exempt? Excess income and excess resources are treated
in the same way, here in New York. A Medicaid applicant will receive medical
assistance as soon as medical expenses exceed excess income or resources. One
can use those medical expenses to spend-down income or resources, but not both
simultaneously. Once the excess income or resources have been off-set, then
Medicaid benefits will be paid.
The above list is for general information purposes
only. It is not intended to constitute individual legal advice or a specific
recommendation to any particular client./font>
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