Myths About Medicaid

Myth: I cannot become eligible for Medicaid because my assets are too high. Fact: Applicants for Community Medicaid in New York State must have less than $14,250 (for a single person) or $20,850 (combined assets for a married couple). An applicant's residence does not count as an asset if the market value of the home, minus the amount mortgaged, is less than $750,000. Applicants with assets higher than the Medicaid limit can reduce them by spending them down to the limit or by transferring them to a trusted family member or an irrevocable trust. If you have significant assets, you should consult with an elder care attorney about how best to reduce them. Once you have reduced your assets to under the limit, you are eligible to apply for Medicaid in the following month. (By Roy Herndon Smith) Myth: I cannot get Medicaid because my income is too high. Fact: The Community Medicaid income limits are $792 a month for a single person and $1,159 for a married person. You can still apply and qualify for Medicaid if you have income over these limits. Medicaid treats such "surplus" or "excess" income as a deductible. For instance, if you are a single person with an income of $1,292 a month, you have a surplus of $500. If you have $1,400 of medical expenses, including home care, in a month, Medicaid will only pay for $900 of those expenses; you will be billed for $500. However, you can use a pooled income trust to protect your surplus income. Once Medicaid recognizes that you are disabled and are depositing your surplus into a pooled income trust, it will pay for all the covered medical expenses, including home care. You will not be billed for the surplus amount. You can have the trust use almost the entire surplus to pay for your regular bills, such as rent and utilities. New York City's Human Resources Administration can take a long time, sometimes over 3 months, to approve Medicaid and Medicaid home care. Applicants, especially when they have surplus income and are using a pooled income trust, often face delays and difficulties and need expert help to deal with them. For these reasons, if you foresee needing Medicaid to pay for home care in the future, you should start preparing to apply now by calling a knowledgeable geriatric care manager or social worker. Roy Herndon Smith, Ph.D., is with Community Geriatric Care (communitygeriatriccare@gmail.com), a subsidiary of Foremost Home Care.