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Advocacy to Improve the Medicaid Spend-down Program in New York State
In May 2009, the New York State Health Foundation issued a report titled Streamlining New York's Excess Income Program, written by Manatt Health Solutions. The report presents a clear picture of the daunting complexity of the Excess Income or “spend-down”...
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Elimination of resource test for adults in Family Health Plus and many adults in Medicaid
Beginning January 1, 2010 the resource test for all adults in Family Health Plus and many adults in Medicaid is eliminated. There is no resource test for Medicaid recipients who are Singles/Chlldless Couples (S/CC)(over age 21 and under age 65 and not disabled and not caring for...
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Keeping Medicaid after Cash Public Assistance or SSI Benefits Are Terminated
Scenarios: Susie is 49 years old and single, with no children. She has been receiving cash public assistance and Medicaid for three years, while she appeals the denial of Social Security Disability Insurance Benefits ("SSD" or "DIB"). She finally was approved for SSD, and will start receiving...
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Medicaid Resource and Income Disregards
When determining eligibility for Medicaid in New York state, the local district determines the gross income and resources of the applicant, and then deducts certain items which may be disregarded. If any of these disregards apply to a particular applicant, then they may be eligible for Medicaid...
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Financial maintenance requirements at application and renewal
In September, 2011, NYS Department of Health (DOH) clarified the administrative directive 10ADM-06 Standardized Financial Maintenance Requirements for Medicaid Applicants/Recipients, which in June, 2010, established a standardized methodology by which local social...
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Medicaid Alerts & Other Protocols published by the NYC HRA Medicaid Program
HRA Medicaid Alerts are periodic announcements of policy, staff and office changes published by the HRA Medicaid Progarm (formerly called the "Medical Insurance and Community Services Administration (MICSA)". The Medicaid Program is the part of New York City’s Human Resource Administration...
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New York Medicaid Expansion
Know Your Rights: What You Need to Know About NYS Medicaid Expansion in 2023 This year’s Health Budget makes significant changes to New York’s Medicaid program – expanding eligibility to 133% of the federal poverty law (FPL) and changing budgeting rules and enrollment processes for...
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AIDS Drug Assistance Program (ADAP) and other AIDS/HIV Subsidy Programs
AIDS Drug Assistance Program (ADAP) What are ADAPs? AIDS Drug Assistance Programs (ADAPs) provide HIV-related prescription drugs to low-income people with HIV/AIDS who have limited or no prescription drug coverage. With more than 210,000 enrollees nationally in FY 2013, ADAPs reach...
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NYS Medicaid Codes - What do they Mean?
When you prepare for a fair hearing and obtain an evidence packet, and in some other instances, you obtain screenshots from the eMedNY system - the computer system that stores Medicaid eligibility information, which providers use to look up eligibility of their patients. Local Medicaid offices or...
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What You Need to Know About Lump Sum Payments and Medicaid Eligibility
By the Legal Aid Society Information about receiving a lump sum payment from Medicaid and how it may affect your eligibility or coverage. If I receive a lump sum payment, like a court settlement, workers’ compensation payment, or inheritance, will it affect my Medicaid coverage? How a lump...
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What You Need to Know About Medicaid Spenddowns
By the Legal Aid Society A Medicaid spenddown is when your monthly income is more than the income limit for Medicaid. The difference between your income and the Medicaid limit is called a “spenddown” or a “surplus.” You also might be told you are “over-income” for Medicaid or have...
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Nursing Home Medicaid Coverage - Basic Financial Eligibility Rules about Income, Resources, and Spousal Protections
Medicaid rules are different for people living in the "community" than people living in institutions. For this article, the word "institution" means nursing home care. If you live in your home, someone else's home, or an Assisted Living Program, you are considered to live in the "community." ...
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