New York Imposes Restrictions on Medicaid Eligibility for Home Care

New York was the only state that didn’t have a look-back period for Medicaid home care, but that is now changing. New York Medicaid applicants will no longer be eligible for home care if they gave away assets within 30 months of applying.

Medicaid, unlike Medicare, is a means-based program, which means that you are only eligible for it if you have very few assets. The rules are slightly different for nursing home benefits and home and community-based care benefits.

With regard to nursing home benefits, states are required to impose a penalty period on Medicaid applicants who transfer assets without receiving fair value in return. States require a person applying for Medicaid to disclose all financial transactions he or she was involved in during the five years before the Medicaid application. This five-year period is known as the “look-back period.” The state Medicaid agency then determines whether the Medicaid applicant transferred any assets for less than fair market value during this period.

With regard to home and community-based benefits, states have more leeway with the rules. Previously New York imposed a five-year look-back period for Medicaid applicants applying for nursing home care, but no look-back period for Medicaid applicants who applied for home care or community-based care. An applicant could give away all his or her assets and then apply for Medicaid community-based care the next day.

Under the new law that went into effect October 1, 2020, applicants for home or community-based care in New York will have to disclose if they transferred assets for less than market value in the 30 months (two and half years) before applying. Applicants who transferred assets will face a penalty period.

For more information about Medicaid’s rules, click here.