Planning for Medicaid: NY Medicaid 101

Medicaid eligibility is complicated, and it changes from time to time. The application is lengthy and involved. Many applications are denied for simple issues like a missing signature or incorrect date. As an entire generation of “Boomers” retires, seniors and their families need to understand what Medicaid is and whether they qualify. Here is an outline of Medicaid and some questions that you may be asking.

What’s the difference between Medicaid and Medicare?

Medicaid and Medicare are distinctly different. Just because you qualify for one doesn’t mean that you are eligible for the other. Some people will qualify for both, and that’s called “dual eligibility.”

What is Medicaid?

Per the New York State Medicaid web page, Medicaid is health insurance for people who cannot afford traditional health insurance plans. You may be covered if you meet specific asset requirements, you receive supplemental security payments (SSI), or if you have high medical bills. There are no specific age guidelines. 

What is Medicare?

Medicare Part A is a federal benefit that you earn by working throughout your lifetime. If you’ve earned a traditional paycheck, or if you’ve paid self-employment taxes in the years leading up to your retirement, you’ll probably be eligible. It’s only available to seniors age 65 and older, and it covers hospital visits. Additional health insurance like Part D for prescription medication and Part B for doctor visits are available to seniors, but they usually come at a cost. 

Now that you know the difference, most people wonder if they will qualify for Medicaid.

What are the income/asset levels for Medicaid in NY?

Medicaid is health insurance for individuals who cannot afford other types of health insurance. And the state may take a “five-year look back” at your finances to make sure you’re genuinely eligible. 

Generally speaking, the income levels for Medicaid look like this:

  • A single individual can earn $17,609 annually or $1,468 per month
  • A family of two can earn $23,792 yearly or $1,983 per month
  • Larger families have higher income limits

Remember, income from rental properties is included in this tally. And that makes sense. New York taxpayers shouldn’t be on the hook to cover health insurance costs for a person with real estate income just because they’re not formally employed.

Why Medicaid planning matters

It’s no secret that seniors face an expensive reality when it comes to health care. The costs of hospitalizations, doctor visits and nursing home bills can all be mitigated with thoughtful Medicaid planning.



FindLaw Network