Impactful Medicaid Changes Postponed What to Expect in 2024

Since the enactment of the 2020 NYS budget, advocates have been on the lookout for what are expected to be meaningful changes to the Medicaid program, from financial and medical eligibility, to how assessments are conducted. Fortunately, some of these critical transformations have been delayed and will likely not go into effect in 2024.


The most significant of the anticipated changes is the implementation of a 30-month lookback in determining eligibility for community Medicaid. Community Medicaid pays for long term care in the Applicant’s home, i.e. home health aides. Home health aides assist with activities of daily living such as eating, walking, bathing, dressing, personal hygiene, toilet use (including diaper changes), transferring (in and out of bed, on and off a chair or toilet) and bed mobility also known as turning and positioning. They also help with things like cooking, cleaning, shopping, and paying bills.


The implementation of a 30-month lookback means that an application for home care benefits will require the submission of 30 months of financial information preceding the application/date services are expected to commence. The Department of Social Services will then determine if transfers were made for less than fair market value and impose a penalty period or period of ineligibility for Medicaid based upon the value of the uncompensated transfer. This may result in the Applicant’s having to pay for aides, out of pocket, for up to 30 months. Home health agencies currently charge anywhere between $28-45 per hour. As you can imagine, paying for care at home is, for many individuals, prohibitive.


The good news is that, due to several factors, the Medicaid homecare 30-month lookback wil likely not go into effect in 2024. Indeed, it is not expected to be implemented until at least March 2025. This does not, however, mean that you should delay in Medicaid planning. Quite the opposite. If your goal is to age with dignity in your home, the time to plan is now.


In other news, in 2023, the limits for financial eligibility for Medicaid increased significantly, making it easier to qualify for Medicaid benefits. Currently, the resource limit for a house- hold of one is $30,182.00 and the income limit is $1,677.00. For a household of two, the resource limit is $40,821.00 and the income limit is $2,268.00. This increase in one’s resources allows Applicants to continue to afford to remain in their homes and still qualify for community Medicaid benefits. Owning a home does not disqualify one from receiving Medicaid benefits. In fact, in 2024, if an Applicant’s primary residence does not exceed $1,071,000 in value, ti is considered an exempt resource for as long as services continue to be provided at home or a spouse, minor or disabled child also lives in the home).


It is important you speak to a legal professional versed in the complex Medicaid rules to determine the best way to tackle your Medicaid plan today. Call us and schedule a consultation.