New York Health Access - Recent Articles

Recent Articles

	Medicaid Assisted Living Programs (ALP) in NYS INTRODUCTION The Assisted Living Program provides supportive housing and home care services to individuals who are medically eligible for placement in a nursing facility but, whose needs can be met in a less restrictive and lower cost residential setting. he operator of the assisted living...


	The Medicaid Buy-In for Working People With Disabilities (MBI-WPD) The Medicaid Buy-in for Working People with Disabilities (MBI-WPD) expands eligibility for individuals with disabilities under age 65 who have work income. Under MBI-WPD, individuals are eligible for full Medicaid benefits at much higher incomes than individuals who are not working. The income...


	Spousal Impoverishment Protections for Married Couples where One Spouse is in a Managed Long Term Care Plan - Pooled Trusts Allowed as an Option In this Article KNOW YOUR RIGHTS: Download Consumer Fact Sheet on Tips for Keeping More Income, including Spousal Impoverishment Protections.: What are Spousal Impoverishment Rules? Which Married couples can Use Spousal Impoverishment Protections? Spousal Impoverishment...


	Income and Resource Limits for New York State Public Health Insurance Programs Big increases in income and asset limits for Age 65+, Blind & Disabled (ABD) took effect Jan. 1, 2023 - read about how these were rolled out here. and see these DOH directives: 3/1/24 UPDATE - NYS Dept. of Health updated the income and resource limits based on the 2024 Federal Poverty...


	Special Medicaid Income Rules That May Eliminate Your "Spend-down" or "Surplus Income" Many people age 65+, Disabled or Blind would normally have an income "spend-down" because their income is above the non-MAGI limits (which are in BOX 1 of the HRA Income & Resources chart ). This Fact Sheet explains the basic rules of Non-MAGI Budgeting used for people age 65+, Disabled, or...


	"Immediate Need" Fast-Track Application for Medicaid and Personal Care or CDPAP - Independent Assessor Starts Dec. 1, 2022 Medicaid has a fast-track procedure to apply for Medicaid in order to obtain home care services, which has been faster than enrolling in a managed long term care plan. Click here to learn about the reasons for MLTC enrollment delays. The 2015 New York law requires approval of Medicaid in only...


	Advocate's Outline on Supplemental Needs Trusts and Rules for Impact of Lump Sums on Various Benefits This in-depth training manual or outline (updated June 2023) covers how Supplemental Needs Trusts work (both individual and pooled), when an asset or lump sum may be deposited into an SNT. For Community Medicaid only, income may also be placed into an SNT. Explains how lump sums and SNTs affect...


	Emergency Medicaid in New York State - Limited Medicaid Coverage for Undocumented Immigrants & Changes for Age 65+ NEWS ALERT: January 1, 2024 - Undocumented immigrants age 65+ became eligible for full Medicaid (as opposed to only Emergency Medicaid). See this article to learn how this expansion is being implemented, and Download the official Fact Sheet - New Health Insurance Option for...


	NYS Essential Plan - Expands April 2024 from 200% to 250% Federal Poverty Level The NYS Essential Plan (EP) will have expanded eligibility levels starting April 1, 2024, under a recently approved federal 1332 Waiver program. Until now, EP covered individuals who are over income for Medicaid (with incomes between 139%-200% of the FPL) and some lawfully present immigrants who...


	Maintaining Community Medicaid Budgeting and SSI Benefits During Temporary Nursing Home Stays Many Medicaid recipients are admitted to nursing homes but plan to return to their homes in their community. Financially, they need to maintain income so that they can continue to pay rent, utility, and other living expenses to preserve their apartment or home for their return. However, both...


	Medicaid for Undocumented Immigrants Age 65+ - Starts January 2024 Starting Jan. 1, 2024, immigrants age 65+ can get FULL MEDICAID even if they do not qualify for PRUCOL status (PRUCOL is discussed in this article). This include most services - including home care, prescription drugs, and Nursing Home care. See more below about services covered. Until now,...


	Medicaid Transportation in NYS States are required under federal regulations (42 C.F.R. §431.53) to assure necessary transportation to Medicaid beneficiaries to and from medical services. When travelling to medical appointments, a Medicaid beneficiary is expected to use the same mode of transportation as the beneficiary...


	Expanded Medicaid Dental Benefits - Effective 1/31/24 New York’s Medicaid program includes limited dental benefits. The coverage has been expanded beginning on January 31, 2024 as the result of the settlement of the Ciaramella v. McDonald case (originally Ciaramella v. Zucker). This article will go over general Medicaid dental rules and common...


	How to use a pooled SNT to eliminate the Medicaid spend-down. This Fact Sheet explains how to use a Pooled Supplemental Needs Trust to eliminate the Medicaid spend-down (updated for 2023) - See SPANISH TRANSLATION. N. Y. Social Services Law § 366, subd. 5 (f) - Law enacted Dec. 18, 2017 - NEW LAW enacted that requires the State Dept. of Health to...


	Step-by-step guide to enrolling in a pooled income trust for Medicaid spend-down This article is a condensed road-map for using a pooled income trust to eliminate the Medicaid spend-down. NEW June 2022 - Big Changes in NYC - See STEP TWO and STEP Three below - NEW DISABILITY forms required! DOWNLOAD OUR our longer FACT SHEET on this topic (updated May 2023 to reflect...


	Medicaid Consumer Directed Personal Assistance Program (CDPAP) in New York State FEBRUARY 2024 ALERT - Learn about proposed CDPAP CUTS in NYS BUDGET - HERE 2023 UPDATE - see directives issued Oct. 2023 here clarifying that a legal guardian may be a personal assistant in CDPAP if someone else is the "designated representative. In 2020, NYS enacted restrictions on...


	Medicare Savings Programs (MSP) in New York Medicare Savings Programs (MSPs) pay for the monthly Medicare Part B premium for low-income Medicare beneficiaries, qualify enrollees for the "Extra Help" subsidy for Part D prescription drugs, and for those in QMB - pay Medicare coinsurance and deductibles. As of 2023, there are TWO separate...


	Special Income Standard for Housing Expenses: If Discharged from Nursing Homes or Adult Homes & Enroll in or Remain Enrolled in MLTC Plan A huge barrier to people returning to the community from nursing homes is the high cost of housing. One way New York State is trying to address that barrier is with the Special Housing Disregard that allows certain members of Managed Long Term Care or FIDA plans to keep more of their income to pay...


	Transfer of Asset Rules in Medicaid -- The Deficit Reduction Act of 2005 The Deficit Reduction Act of 2005 (DRA, enacted in 2006, made major changes to the transfer penalty rules for eligibility for Medicaid to pay for nursing home care. At the time, and until now, nursing home care was the only Medicaid service that had a lookback and transfer penalty.See GIS 06...


	KNOW YOUR RIGHTS: Fact Sheet Explaining Basic Rules on NYS Financial Medicaid Eligibility for People who are Disabled, Aged 65+, or Blind This Fact Sheet (updated 02/20/2024 with 2024 figures) explains Medicaid eligibility for New Yorkers who are age 65+ or who have disabilities. It explains the basic financial rules on eligibility for Medicaid in the community for this category of people, and explains how to apply for Medicaid if...


	Medicaid Managed Care Law and Regulations STATE - N.Y. Soc. Servs. L. §364-j (Amended L. 2011 Ch. 59). Regulations at 18 NYCRR 360-10. FEDERAL - 42. C.F.R Part 438 (amended extensively in 2016, with changes going into effect in NYS on rolling basis, including new appeal rules starting May 1, 2018 requiring...


	About Us This site is made possible in part by grants from the New York State Office for Aging and the New York Community Trust. We are also grateful to Western New York Law Center for hosting the site. We are grateful to Selfhelp Community Services, which housed the Evelyn Frank Legal Resources Program...


	NYS Medicaid Application Form (updated 2021) for Age 65+ or Disabled or Blind - New Supp A NYC 2021 Since 2010, the New York State Department of Health Medicaid application form is called the Access NY Application or Health Insurance Application or form DOH-4220. Download the most recent version of the form at this link. (As of 02-06-24, the form was last updated in January 2023.) For those...


	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...


	Medicaid Contacts in New York City (NYC Human Resources Administration - MICSA) Since May 2013 the NYC Medicaid Office has been located at 785 Atlantic Ave., Brooklyn, NY 11238. The Reception Unit is on the main floor of 785 Atlantic Ave.Brooklyn NY 11238. The table of contacts below is compiled from these Alerts issued by HRA: See HRA Fax/E-mail Submissions to HRA...