New Deadline – MARCH 31, 2021
The 2020 N.Y. State Budget Bill included changes to the Medicaid program covering home and community-based services (Home Care):
- All new applications for Medicaid community-based (home care) have a lookback period when analyzing an applicant’s resources and income.
- If gift transfers are made after October 1, 2020, a transfer penalty or waiting period may be applied before Medicaid covered services can be granted.
The effective date for this new rule is April 1, 2021. All Medicaid home care applications filed after March 31, 2021 will be asked to incrementally provide 30 months of financial statements for all resources. If uncompensated transfers or gifts were made to establish Medicaid eligibility, a waiting period for benefits will be applied in proportion to the amount of the gift and the timing of the gift.
These rules may also affect existing Medicaid home care beneficiaries who participate in pooled income trusts. Pooled trust recipients in making their monthly transfers to their pooled trust may need to limit the remaining pooled trust balance to Medicaid’s current resource amount. ($15, – 2021) combined with their other exempt resources.
Please note that the lookback period for Medicaid nursing home benefits remains unchanged at a full 60 months (5 years).
Look for future mailings on other Medicaid topics as listed below:
- More Medicaid home care members who have been in a nursing home for 3 or more months will be unenrolled from MLTC plans on April 1st if they were approved for Nursing Home Medicaid
- NEW “LOCK-IN Rule” Started December 1, 2020 which limit Medicaid home care recipients ability to switch home care agencies after a certain time frames.
- 2021 Medicaid Income Limits announced.
- Medicaid and Services Levels Cannot be Reduced or Stopped During COVID Emergency as per federal and state rules
If you need to avoid the new 30 month look back and a possible Medicaid penalty period please contact as soon as possible to develop your Medicaid plan. We can also explain how this rule will impact the continued use of a pooled income trust.