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  • Writer's pictureNicole J. Zuvich

How to qualify for Medicaid to pay for long-term care

Updated: Sep 27, 2022

The Department of Human Services states that most adults over 65 can benefit from long-term care services and support. Many adults worry about covering care costs or depleting their savings and assets.

These are helpful answers to questions about qualifying for Medicaid to help cover the long-term care costs many adults require.

What is the Medicaid asset limit?

In New York, the current qualifying limit for Medicaid is $18,085 for individuals and $24,353 for married couples. However, households exceeding these limits do not automatically forfeit eligibility.

What is the lookback period?

New York law requires Medicaid to review applicants’ assets over 30 months to five years before submitting their applications, depending on whether they need nursing or in-home care. The look-back process determines whether applicants legitimately meet the financial eligibility requirements. Those who gift or transfer assets they could otherwise use to pay for their long-term care costs may be subject to extended waiting periods or disqualification for benefits. However, transferring assets into an irrevocable pre-need funeral account is an example of an acceptable solution.

How can you qualify with excess income?

Seniors can also obtain Medicaid benefits by applying the difference between the state’s asset limit and their gross monthly income to medical expenses that Medicaid does not cover. Thus, they can reduce their assets to the qualifying amount, and Medicaid may pay for subsequent medical services relating to their long-term care needs.

Making spend-down payments to a managed long-term home care plan provider is also acceptable. Although plan participants will not lose their Medicaid benefits for non-payment, they risk losing eligibility for their managed care plans.

It is essential and practical to create a plan for addressing your long-term care to protect your future and that of your loved ones.

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