In New York, Medicaid can help pay for medical care and services for long-term care, home health assistance and an assisted living facility, and it also provides seniors with the medical equipment, transportation and supplies necessary to ensure quality of life.
Those who have limited financial income may receive low-cost or free medical assistance through the NYS Medicaid State Plan. To be eligible, an individual must be age 65 or older, a resident of the state of New York and a U.S. citizen (or have satisfactory immigration status). To meet financial requirements, single seniors’ income must be $842 per month or less, and couples must have an income of less than $1,233 per month. Non-exempt assets cannot exceed $15,150 for a single candidate and $22,200 for couples.
You may still be eligible for Medicaid if your income is a bit over the limit with the Medicaid Excess Income program, also known as the spend-down or surplus-income program. The amount of your excess income is similar to a deductible; once your medical bills meet the requirements for a particular month, Medicaid pays your additional medical bills for the remainder of that month.
Medicaid usually has 45 days to process your application, and if the application requires a disability determination, the agency can take 90 days. Applications may be processed more quickly if:
- You don’t have caretakers able and willing to provide care
- You aren’t receiving the necessary assistance from a home care service agency
- You have no third party insurance or Medicare benefits
- You don’t have the adaptive or specialized equipment required to meet your health needs
Once eligibility has been firmly resolved, you will receive notification in the mail with further instructions.
The NY Assisted Living Program (ALP) is a waiver that pays for the services of a licensed assisted living residence for individuals who require a certain level of care, but doesn’t need the in-depth services of nursing home care. To qualify, individuals must be age 21 and over, have a degree of self-mobility to function in an assisted living environment and meet the income limits of Medicaid recipients. Services paid by ALP include personal care, skilled nursing, room and board, occupational and physical therapy and personal emergency response services. This program is open to Medicaid-eligible and ineligible individuals.
The ALP is regulated by the State Department of Health and has limited enrollment, so it’s not unusual to be placed on a waiting list. To apply for Medicaid, call (855) 355-5777, apply online or visit the local office in your area.