Medicaid is a government health care program that provides coverage to millions of low-income individuals, pregnant women, seniors and those with disabilities. For eligible recipients who live in New York, the state administers benefits. Recent changes to the state budget are likely to affect Medicaid eligibility.
New York’s new Medicaid rules took effect on October 1, 2020, marking the most significant reworking of Medicaid provisions in recent years. Just as these changes may make it more difficult for New Yorkers to obtain long-term medical care, they may also require additional Medicaid planning.
30-month look-back period
Arguably, the biggest change to Medicaid rules affects the look-back period for Community Medicaid, the health program that covers at-home care. Those who want Community Medicaid benefits must now provide financial information for the previous 30 months. If you have a transfer of funds or acquisition of certain assets during this period, Community Medicaid may not pay for at-home care.
Medicaid has a Consumer Directed Personal Assistance Program. If individuals qualify for this program, friends or family members may provide in-home care while receiving compensation from Medicaid.
The new Medicaid laws in the Empire State now state individuals must need assistance with at least three activities of daily living to qualify for CDPAP participation. These include the following:
- Personal hygiene
- Other activities of daily living
While the changes to New York’s Medicaid laws are likely to affect many New Yorkers, it is still possible to obtain the benefits you or a loved one deserves. Nevertheless, you may need to think carefully about estate planning and asset protection to ensure you do not lose access to Medicaid benefits.