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UPDATED: New 2021 Medicaid Rates

On Behalf of | Jan 28, 2021 | Medicaid Eligibility

As discussed in Anthony J. Enea Esq.’s recent article, “Seniors and the Disabled Get a Needed Reprieve from the Imposition of the new Penalty and Lookback Period for Community Medicaid,” and Samantha Lyons Esq.’s blog, “New 2021 Medicaid Rates,” the new look back for community Medicaid that was set to take effect on April 1, 2021 has now unofficially been delayed to July 1, 2021. The Families First Act and Cares Act prohibits states from restricting eligibility until the quarter following the end of a Public Health Emergency. The current Public Health Emergency was just extended three months to April 21, 2021. As such, New York State cannot begin the implementation of the new home care Medicaid lookback until the following quarter, which begins July 1, 2021. While this delay has not yet been confirmed, we anticipate receiving confirmation from the Department of Health in the future and will keep you informed as to same.

Please note, as discussed in Anthony J. Enea’s article, once the new lookback is implemented, assets transferred on or after October 1, 2020 will be subject to said lookback.

Additionally, New York State previously announced the 2021 income and resource levels for Medicaid eligibility (GIS 20 MA/13). As the Medicaid program is a “means tested” program, the first step in determining eligibility is looking to the applicant’s income and assets/resources. The new income threshold for an individual applying for community/home care Medicaid is $904 a month ($895 in 2020). The new resource (non-retirement liquid assets) threshold for an individual applying for home care Medicaid is $15,900 ($15,750 in 2020). For a couple applying for home care Medicaid, their eligibility is based on their combined countable resources, which can be no more than $23,400 ($23,100 in 2020).

If you’ve wondered lately about a friend, a neighbor or a loved one, and whether they may need assistance with their activities of daily living, such as assistance showering, dressing, toileting, meal preparation etc., now is the time to seriously consider applying for community/home care Medicaid.

We highly encourage those who have been thinking about applying for community Medicaid to contact us to discuss their current eligibility and the consequences the new look back will have.