Community Medicaid Eligibility

What is Community Medicaid?

Fundamentally, Community Medicaid is health insurance. Yes, financial eligibility is required for both income and resources. In 2020 the limit an applicant can have in resources is $15,750 and $875 monthly income. If the applicant meets the financial requirements he/she can apply for Community Medicaid. Suppose the applicant requires home care services, where a home attendant would visit the applicant on a daily basis and assists them with their Activities of Daily Living (ADLs), such as, getting dressed, toileting, shower, cooking, and feeding, etc. These services are all part of what Community Medicaid has to offer.

The question always asked is what if the applicant has more than the allowed income and resources? Many advisors will tell the applicant to spenddown their life savings before they can apply. Technically speaking it’s an option, but lets explore another option and see if it makes sense for you to choose the later of the two.

Resources:   Today and up until March 2021, applicants can transfer their life savings to anyone, including but not limited to a trust, and become financially eligible the very next month. After March 30, 2021 Medicaid will impose a two and one-half (2.5) years of look-back. This does not mean a two an one-half (2.5) years of ineligibility, but if any money was transferred during the look-back period there will be some ineligibility period. After March 30, 2021 additional strategies will be offered for the applicants to choose from in order to protect some or all of their life savings.

Income:    Suppose the applicant has income from several sources, such as, social security, pension and IRA’s that distribute the required minimum distribution. Lets assume the total is approximately $3,000 per month. Here the applicant has a choice. Either 1) surrender the difference from the $875 allowed to Medicaid or 2) join a Medicaid approved pooled-income-trust. By joining a pooled-income-trust the applicant is allowed to deposit their surplus income to the trust every month and use the money in the trust to pay their bills, such as, rent, cable, credit card, etc.

Care:    Although many applicants are under the impression that Medicaid has its own staff of unqualified home-attendants, it is far from the truth and incorrect. This concept forces potential applicants to prefer a more skillful attendant from a private agency. However, in reality Medicaid has no home attendant! Medicaid hires the private agencies to provide the services. As a matter of fact, the applicant can sometimes keep the same agency they presently have or choose anyone of the many private agencies who are registered with Medicaid.

Conclusion:   If the services are provided by the same attendant that the applicant would pay up to $30 an hour today why deplete the applicant’s life savings when they could be protected and used for additional care or services which Medicaid does not provide.

We file applications in NY County, which includes, Manhattan, Brooklyn, The Bronx, Queens and Staten Island, as well as, Nassau, Suffolk, Westchester, Rockland, Putnam, Orange, Sullivan and Dutchess Counties.