Medicaid is a government-sponsored program that helps low-income people access the healthcare they need. Seniors, children and pregnant women are some of the groups that Medicaid assists. While the federal government contributes to the cost of Medicaid, each state runs its own program. New York Medicaid covers many services, including:
- Doctor visits
- Medical supplies
- Medical equipment, such as wheelchairs
- Emergency care
- Nursing home care
- Hospital stays
New York Medicaid may also help pay for assisted living care through two programs: the Assisted Living Program and the Managed Long-Term Care Program.
Niagara Falls residents may qualify for New York Medicaid if they are U.S. citizens, U.S. nationals or people with an approved immigration status. Household income is also considered when
determining eligibility for Medicaid. Single seniors may qualify if they earn less than $15,800 per year before taxes. For two-person households, the yearly income limit is $21,307.
For seniors, there is also a
resource test. To be eligible for Medicaid, a senior needs to have less than $2,000 in resources ($3,000 for couples). A home, car and personal property aren’t counted as resources. Some of the assets that are counted toward these limits include:
- Cash
- Bank account balances
- Stock portfolios
- Vacation homes
- Life insurance policies
People who don’t have a low income and limited resources may qualify for the
Medicaid Excess Income Program. This program, also known as a spend-down, can be helpful for people with high medical bills. Participants use their surplus income to pay for their own medical bills, and if they spend enough to reach the Medicaid income limit, Medicaid kicks in and pays for the rest. Participants who need medical care but don’t have any medical bills can pay their surplus income directly to the Department of Social Services.
To apply for Medicaid online, visit the
New York State of Health website. To apply over the phone, call the Medicaid helpline at (800) 541-2831.
Assisted Living Program New York’s Assisted Living Program provides a variety of services to participants. These services include personal care, supervision, housekeeping, physical therapy and occupational therapy. Seniors may also receive assistance paying for room and board.
To participate in the ALP, seniors need to be medically eligible to live in a nursing home. They must be able to live safely in an assisted living facility and not be bedbound or in need of continuous nursing care. While the majority of participants in this program are Medicaid recipients, private payers are also eligible.
Seniors who are interested in these services can contact the ALP directly. Participants receiving Medicaid must also contact
Niagara County Social Services to have ALP services approved. This department can be reached at (716) 278-8400.
Managed Long-Term Care The
Managed Long-Term Care program may help seniors pay for assisted living and other long-term care options. There are
three different plans: MLTC Medicaid Plus, Medicaid Advantage Plus and Program of All-Inclusive Care for the Elderly. The first plan only provides Medicaid services while Medicaid Advantage Plus and PACE provide both Medicaid and Medicare services. Some of the services provided by these plans include:
- Home health services
- Personal care
- Adult day health care
- Nursing home care
- Transportation to medical appointments
Membership in the MLTC program is mandatory for seniors who are dual-eligible for Medicaid and Medicare and will receive long-term care for at least four months. Seniors who are enrolled in the ALP, which was described in detail above, cannot join the MLTC.
To learn more about MLTC or to join, call New York Medicaid Choice at (888) 401-6582.