Chronic Medicaid vs. Community Medicaid

In New York, Community Medicaid helps cover the cost of home care and Chronic Medicaid pays for all or part of nursing home care. However, there are certain income and asset requirements that apply to these Medicaid programs because they are need based.

To be eligible for both Community Medicaid and Chronic Medicaid a person can have no more than $14,850.00 in non-qualified liquid assets in their name. Retirement assets may be in the person’s name so long as they are taking the required monthly minimum distributions.

An individual’s primary residence is an exempt asset. An individual is allowed to pre-pay for their funeral expenses as long as it is irrevocable. An individual may have no more than $845 in monthly income. However, you can preserve excess income by forming a Pooled Income Trust.

In New York, Community Medicaid has no look back period. This means that an individual is immediately eligible for community Medicaid within one month.

For Chronic Medicaid the primary home is not automatically exempt. The residence is exempt only in circumstances where there is a spouse, minor, disabled or caretaker child living in the home. It may also be exempt if the Medicaid recipient shows an intent to return to the home.

For Chronic Medicaid all of the income must be used for the cost of care. The recipient is allowed only $50 per month to be exempt. Also, if a spouse is earning less than $2,890.50 they may keep a portion of their spouse’s income in order to bring them up to that amount.

Chronic Medicaid has a five-year look back period. This means that if there were any assets or money transfers made within five years from the date of filing a Medicaid application, all of that information must be fully disclosed and there could potentially be penalties imposed for those transfers. Some transfers, such as those to spouses, are exempt from penalty.

Protecting assets and ensuring that you or your loved one is eligible for Medicaid can be complex. The staff at P&P Medicaid Consulting, Inc. are experienced in handling all aspects of Medicaid eligibility and application. We utilize programs and planning options to meet Medicaid’s income requirements and protect a family’s income and assets. Contact our Long Island, New York Medicaid consulting office at (516) 541-4770 for a consultation.

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