Medicaid, a joint federal and state program designed to assist seniors with the staggering costs associated with long-term care, is a godsend for many New Yorkers. Unfortunately, applying for Medicaid in New York presents a labyrinth puzzle not easily deciphered, often leaving New York Medicaid applicants and their families with more questions than answers.

The regulations and requirements of New York Medicaid are complex and are constantly evolving, making the risk of failure quite real. A small mistake can result in a denial of coverage and significant financial losses.

However, the NY Medicaid application process need not be tackled alone. At Senior Planning Services, we are entirely focused on helping families navigate the maddening Medicaid maze and achieving the benefits they deserve. We offer a comprehensive service and assist in every aspect of the NY Medicaid application process, from the initial consultation through the final approval. We’ll be right by your side until you are approved for the benefits you need.

Need to Apply for Medicaid in NYC? We can help!

Contact Senior Planning Services today to learn more

Asset allowances document checklist

What is Medicaid, and Why Do I Need It?

Medicaid is a safety net. Today, Medicaid is a program that provides health coverage to over 60 million Americans, but from the very beginning, it was created with seniors in mind. Quality long-term care is exceedingly costly, and with the ever-growing life expectancy rate, it is almost entirely unavoidable. Even if someone works their whole life, studiously putting away a portion of their earnings, chances are, they will still be short on funds if they are committed to a skilled nursing facility. The average cost of a nursing home in New York is $10,000 per month, or $120,000 per year. If you qualify for Medicaid-assisted living in New York, these costs can be offset, ensuring you receive a high level of care even if your savings cannot pay for it all.

Medicaid Eligibility NY - Can I Get Coverage?

New York State Medicaid eligibility depends on several factors. The Medicaid program is designed to help people pay for the often-staggering costs of nursing homes and other long-term care options, but there’s a caveat. You must adhere to numerous rules and regulations and provide multiple Medicaid-required documents to receive benefits.

To qualify for long-term care under Medicaid in New York, you must:
• Be a legal U.S. citizen or qualified alien
• Be a resident of New York
• Meet income and asset requirements
• Be 65 years of age, blind, or permanently disabled

Financial Requirements

Requirement 1

To qualify for NY Medicaid, one must be a 65+ and/or disabled US citizen or qualified alien.

Assets

Medicaid nursing home eligibility in New York also depends on the assets an individual owns. To be eligible for NY institutional Medicaid, one must spend down their funds until they reach the Medicaid asset limit. As of 2024, the Medicaid asset limits in New York are $31,175 for a single person and, $42,312 for a couple in which both spouses are getting onto NY Medicaid.

It should be noted that Medicaid does not allow gifts or transfers within five years before getting onto Medicaid. If Medicaid does locate a gift or transfer, they will impose a period of ineligibility for Medicaid coverage. The period of ineligibility is also referred to as a penalty, and it will correspond to the amount of money that was gifted or transferred. Medicaid seeks to see the last five years of an applicant's financial transactions (there are some excludable transfers that Medicaid will allow an individual to do).

Financial statements

It is also important to note that Institutional Medicaid New York requests to see the last 60 months of financial statements for the Medicaid NY applicant. If Medicaid locates any gifts or transfers in the financial history within the five years prior to the NY Medicaid eligibility date, a penalty will be imposed. A penalty is a span of time that an applicant will be ineligible for Medicaid, and will correlate to the amount of money that was gifted. Outlined above are some of the basic NY Medicaid eligibility requirements; however, there are many caveats and exceptions to these rules that need to be taken into consideration.

Why You Will Gain From Applying for Medicaid for Seniors in NY With SPS

In a word: expertise.
At Senior Planning Services, this is what we do all day, every day. Our New York Medicaid specialists have the resources, relationships, and know-how to help our clients maximize their benefits. With vast experience in the New York Medicaid guidelines, we get the job done quickly and efficiently. We don’t just guide individuals, couples, and families through the Medicaid process; we shoulder the burden to provide all the answers and alleviate all concerns during this particularly overwhelming junction of life. Whether you need assistance with a first-time application or with your New York State Medicaid renewals, our team is ready to help. Contact Senior Planning Services today to be put in touch with an expert New York Medicaid planner and enjoy a seamless application process.

Benefit From Our NY Medicaid Planning Services

Offer a free Medicaid Consultation
Gather 60 months of bank and financial statements from the financial institutions' back offices.
Obtain verifications from banks regarding deposits and withdrawals
Guide families through the spend-down process
Assist families in utilizing non-countable assets during the spend-down process

Obtain missing documentation from Vital Statistics, if necessary
Update the client on the status constantly
Interact with the Department of Social Services caseworker regularly
Submit the application to the county Department of Social Services

The experts at Senior Planning Services are just a phone consultation away.
Let us replace your stress and anxiety with direction and clarity.

Give us a call at 855.775.2664 or

Medicaid for Seniors in NY FAQs

How do you apply for Medicaid in New York?: Apply for Medicaid in New York by submitting an application through the NY State of Health Marketplace online, by phone, or in person at your local Department of Social Services. Provide proof of identity, residency, income, and any required documents. Medicaid eligibility in New York is based on income, household size, and immigration status, as well as other factors detailed above. If you need support with your application, Senior Planning Services is dedicated to helping seniors qualify for Medicaid and can assist you with this.
How can I qualify for Medicaid in New York?: Qualify for Medicaid in New York by meeting income limits based on household size, being a state resident, and having U.S. citizenship or eligible immigration status. Pregnant women, children, disabled individuals, and some adults without children may qualify under expanded coverage rules.
What is New York Medicaid called?: New York’s Medicaid program is called NY Medicaid and is administered by the New York State Department of Health. It provides free or low-cost health coverage to eligible residents through the NY State of Health Marketplace or local Department of Social Services offices.
Is Medicaid free for seniors?: Medicaid can be free for seniors who meet income and asset limits set by their state. Eligible seniors receive coverage for medical care, prescriptions, and long-term care without monthly premiums, though some states may require small copayments for certain services.
Who is eligible for Medicaid in New York State for seniors?: New York seniors (65+) qualify if they meet income, asset, and residency requirements, and have a medical need for care. Special programs like pooled income trusts can help those over the limits become eligible.