HRA Medicaid Fax Cover Sheet to Fax medical bills to meet spend-down (2018)

Comments submitted by NYLAG with recommendations and support for New York's request to the federal Medicaid agency CMS to approve a waiver that would expand the MBI-WPD program to include people age 65 and over with higher income and resource limits.

How to get Medicaid despite having "excess income" - Using a Supplemental Needs Trust to Eliminate the Spend-down for Persons who are Elderly (65+), Blind or Disabled. Written by New York Legal Assistance Group Evelyn Frank Legal Resources Program, updated May 2024 with new procedures in NYC for submitting disability forms, and with 2024 figures.

NYLAG Fact Sheet on consumer Right to keep more income during a temporary nursing home stay, as well as after a nursing home stay if a consumer is enrolled in a Managed Long Term Care plan or for some consumers who are married.

Applicants for Medicaid in New York City can use this "APPLICANT/RECIPIENT DECLARATION CONCERNING THE LEGALLY
RESPONSIBLE RELATIVE’S INCOME/RESOURCES" forms to indicate the refusal of their legally responsible relative to make available their income or resources for the cost of necessary medical care and services, i.e. "spousal/parental refusal." Since 2018, includes language to request accommodation of disability in reading notice. Instructions explain whi h form to use - MAP-2161 or 2161a - don't need both. Both attached in same PDF. Other languages availaable of MAP-2161 at https://www.nyc.gov/site/hra/help/health-assistance.page

This fact sheet explains requirements for maintaining SSI (Supplemental Security Income) for up to 90 days during a temporary hospital or nursing home stay. The PDF also includes a new official form (2023) for requesting continuation of SSI benefits, which must be filed with the Social Security Administration within strict timelines. Note that if SSI benefits are terminated, Medicaid will also be terminated, after "Stenson" notices are mailed giving the recipient an opportunity to recertify for Medicaid without SSI. See http://www.wnylc.com/health/entry/85/

The 2023-24 NYS Budget enacted a significant expansion of the MBI-WPD program. Once it is implemented in 2025, the asset limits will go up to $300,000 and the income limits will increase by almost 10 times the current limits for the program. At income levels above the current limits there will be a new premium charged on a sliding scale. This document describes the changes and some concerns for how it ican be implemented in the most favorable way for consumers.

PolicyNet/Instructions Updates/EM-21014: Supplemental Hardship Fund Payments to Jewish Nazi Victims (ssa.gov) - EM 21014 was released in February 2021 with a retention date of February 2022, meaning it has not been available on the SSA website since that date. Nevertheless, the policy remains in effect. See more about the policy here http://health.wnylc.com/health/entry/65/#Hardship%20March%202021

NYC MICSA Medicaid Alerts from 2015 and 2020 with nursing home forms updated as of 3/23/23 including "Discharge Alert" 259d that nursing home physician must sign to certify that resident has a reasonable expectation to return home, which entitles resident to community budgeting (non-chronic care) - so they keep entire community Medicaid allowance rather than only $50/month. Form replaces 1159. PDF includes - Form 259f Notice of Discharge revised 2020 (now includes check-off that resident advised of Special Income Standard for those discharged from NH to MLTC) ; Form 259e (Change/Cancellation of Discharge Plan), 259g (Respite Alert), 259t (updated 5/2020) -- PDF has updated forms as of 3/24/2023 from NYC MARC website.

Transmittal form for Nursing Home to submit to HRA: new Medicaid application, request to convert coverage from community Medicaid, upgrade coverage, or notify HRA that transfer penalty period expired. (updated 5/5/2022)