NYS medicaid Pre 65 - no asset test?

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ButterUtterD
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NYS medicaid Pre 65 - no asset test?

Post by ButterUtterD » Mon Mar 27, 2017 11:05 am

Hi All

This past week I was helping a relative who is 63 years old and was laid of Jan 1 2017. Lay-off was ok and he was planning to retire in the year anyway.

Individual has a paid off 400k home and around 300K in various 1% savings accounts. 1.4 Million in various 401ks Single - not married, no kids. 2017 income will be ~$3000

We worked with an "enrollment specialist" to get him health insurance through the NYS exchange and were surprised to be told that he qualifies for medicaid at zero cost. We are being told that individuals under 65 in the state of NY have no asset based test and its only income based for eligibility.

Googling leads me to various NYS websites that seem to back this up, that this was part of the medicaid expansion act. Despite NYS telling us this, as well as various websites it just seems impossible. Can someone with almost 2 million dollars in assets really qualify for medicaid in this situation?

So at this point he plans to just wait till age 65 for Social Security and live off his checking account until SS and medicare.

Please help me understand if what we are being told is correct

Thanks

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Mlm
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Re: NYS medicaid Pre 65 - no asset test?

Post by Mlm » Mon Mar 27, 2017 11:18 am

Yes, what you are being told is correct. There is no asset test in NY.
Reality has a way of catching up with you

Katietsu
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Re: NYS medicaid Pre 65 - no asset test?

Post by Katietsu » Mon Mar 27, 2017 11:23 am

Not just New York. I believe it is true in all states that offer expanded Medicaid. Expanded Medicaid is based only on current income not on accumulated assets.

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HueyLD
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Re: NYS medicaid Pre 65 - no asset test?

Post by HueyLD » Mon Mar 27, 2017 11:27 am

Googling leads me to various NYS websites that seem to back this up, that this was part of the medicaid expansion act. Despite NYS telling us this, as well as various websites it just seems impossible. Can someone with almost 2 million dollars in assets really qualify for medicaid in this situation?
Yes, it is correct for all states that expanded Medicaid.

However, a lot of millionaires will not tolerate being in Medicaid and they tend to generate just enough income to stay out of Medicaid.

drawpoker
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Re: NYS medicaid Pre 65 - no asset test?

Post by drawpoker » Mon Mar 27, 2017 11:39 am

Be sure he checks into food stamps as well.

Many states (like Maryland) removed the assets/resources limits on the SNAP (food stamp program).
Maybe NY did too?

Just to clarify about Medicaid expansion in the states that adopted it - the rule eliminating the asset test applies only to regular Medicaid for the under-65 crowd. Once your friend turns 65 he will not be eligible to be a dual beneficiary (both Medicare and Medicaid) Assets are counted for that.

Also, for LTSS Medicaid benefits (nursing home bed) the rule about assets still applies.

ButterUtterD
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Re: NYS medicaid Pre 65 - no asset test?

Post by ButterUtterD » Mon Mar 27, 2017 12:03 pm

Hi everyone, thank you for the quick responses.

This is very interesting,it certainly seems that he will get insurance for free.

drawpoker - Out of interest I did look into Foodstamps in NY and you are correct there is no asset test here, only an income test of ~17k a year.

This is all extremely enlightening to me, having just wrapped up my 2016 taxes and paying in excess of 100k in total state and federal tax my brain hurts a bit over it all and I have some serious moral/ethical reservations about it. However my mind is also working overtime thinking about how easily I could retire at an extraordinarily young age and move to a very lost cost area of NY state (leave the metros and NY quickly becomes lower alabama, no negative insult just comparing Costs) , live off a few hundred K in savings , manage my income and pay for little other than housing and leisure.

I guess this begs the question why so many individuals nearing retirement hold out in jobs 'just for the insurance.' It would in-fact seem to be extremely easy to manage ones income while shuffling assets to become eligible. Medicaid despite the stigma does not really appear to be 'bad' insurance. All of the main local drs, hospitals, facilities take it within 100+ miles of me.

Super interesting, thank you.

drawpoker
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Re: NYS medicaid Pre 65 - no asset test?

Post by drawpoker » Mon Mar 27, 2017 12:16 pm

ButterUtterD wrote:k....This is very interesting,it certainly seems that he will get insurance for free.

drawpoker - Out of interest I did look into Foodstamps in NY and you are correct there is no asset test here, only an income test of ~17k a year.
.... despite the stigma does not really appear to be 'bad' insurance. All of the main local drs, hospitals, facilities take it within 100+ miles of me. ...
Not so fast, Butter

Your friend needs to do some more digging. New York, like other states that adopted Medicaid expansion, may also have created PPO type managed care systems to put these beneficiaries into. This is becoming more and more common throughout the U.S.
In other words, would recommend first your friend finds out if he will have to choose one of these groups (similar to Medicare Advantage insurance which utilizes networks, not FSS) to join. Then he will have to check and see if his PCP, plus any other docs he likes, will accept that particular managed care group. In other words, he will have to use docs, hospitals, and other providers who are within that network.

In Maryland, a new enrollee is given a choice of the managed care Medicaid networks and must choose within 30 days. If he/she doesn't choose one, the state will arbitrarily assign one.

So, it may not be correct to assume "All of the main local drs, hospitals, facilities take it within 100+ miles...."

calif.engineer
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Re: NYS medicaid Pre 65 - no asset test?

Post by calif.engineer » Mon Mar 27, 2017 12:24 pm

There are more people in the US on Medicaid than on Medicare. And the federal government spends almost the same money on Medicaid (~$500-600B), as on Medicare and defense.

drawpoker
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Re: NYS medicaid Pre 65 - no asset test?

Post by drawpoker » Mon Mar 27, 2017 12:28 pm

Also, with a projected income that low, he will also be eligible for the energy assistance program.
They don't count assets either. Just goes strictly by whatever monthly income you had in the 30 day period prior to putting in application.

He will get considerable help to pay for both winter heating and summer a/c bills.
Even if he lives in a McMansion :wink:

littlebird
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Re: NYS medicaid Pre 65 - no asset test?

Post by littlebird » Mon Mar 27, 2017 2:13 pm

ButterUtterD wrote:
This is all extremely enlightening to me, having just wrapped up my 2016 taxes and paying in excess of 100k in total state and federal tax my brain hurts a bit over it all and I have some serious moral/ethical reservations about it. However my mind is also working overtime thinking about how easily I could retire at an extraordinarily young age and move to a very lost cost area of NY state (leave the metros and NY quickly becomes lower alabama, no negative insult just comparing Costs) , live off a few hundred K in savings , manage my income and pay for little other than housing and leisure.

I guess this begs the question why so many individuals nearing retirement hold out in jobs 'just for the insurance.' It would in-fact seem to be extremely easy to manage ones income while shuffling assets to become eligible. Medicaid despite the stigma does not really appear to be 'bad' insurance. All of the main local drs, hospitals, facilities take it within 100+ miles of me.
Yes, the ACA does have the effect of making early retirement, or quitting a job to take a chance on a small business easier. That was intentional. But as far as getting your medical care from Medicaid in a rural, depressed area like upstate N.Y., you'd be extremely limited, especially in a serious urgent situation. Which is something that happen more often as we age.

littlebird
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Re: NYS medicaid Pre 65 - no asset test?

Post by littlebird » Mon Mar 27, 2017 2:14 pm

drawpoker wrote:Also, with a projected income that low, he will also be eligible for the energy assistance program.
They don't count assets either. Just goes strictly by whatever monthly income you had in the 30 day period prior to putting in application.

He will get considerable help to pay for both winter heating and summer a/c bills.
Even if he lives in a McMansion :wink:
This kind of help is extremely limited.

ButterUtterD
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Re: NYS medicaid Pre 65 - no asset test?

Post by ButterUtterD » Mon Mar 27, 2017 4:14 pm

Draw - good point on the managed care part, Ill have to research that this week.

Thanks all!

Good Listener
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Re: NYS medicaid Pre 65 - no asset test?

Post by Good Listener » Mon Mar 27, 2017 4:52 pm

It is true. You can be a billionaire. They base it on income. But the relative may not want Medicaid as many of the doctors he/she wants to see won't take it. In HCOL areas, nobody does. I remember helping my helpless sister on the phone when she enrolled for Obamacare the first time. Fortunately I had done some homework beforehand. We did a 3 way call with the NYS folks. Her income at that moment, and I mean for the exact 4 weeks beforehand, was sort of low and as we talked it was clear that the guy on the phone was indicating that she would be on Medicaid. I protested a while but he said it was income based. Without my sister understanding what was needed, an income above the Medicaid threshold to avoid Medicaid, I had no choice but to disconnect the call (I had set it up 3 way). Then we proceeded with a more realistic annual income estimate and enrolled directly with a provider on the exchange. Medicaid is wonderful for people who cannot afford it otherwise. But your relative does not need Medicaid and can enroll directly with a private insurer outside of the exchanges. Good luck.

drawpoker
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Re: NYS medicaid Pre 65 - no asset test?

Post by drawpoker » Mon Mar 27, 2017 7:32 pm

littlebird wrote:
drawpoker wrote:Also, with a projected income that low, he will also be eligible for the energy assistance program.
They don't count assets either. Just goes strictly by whatever monthly income you had in the 30 day period prior to putting in application.

He will get considerable help to pay for both winter heating and summer a/c bills.
Even if he lives in a McMansion :wink:
This kind of help is extremely limited.
In New York? If he was in Maryland, same circumstances, same income, he would be in line for around $550-$750 every year (depending on what fuel he uses for winter heating) NY, being an even higher cost of living area, would likely be more.

Nothing to sneeze at :D

kmurp
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Re: NYS medicaid Pre 65 - no asset test?

Post by kmurp » Mon Mar 27, 2017 7:56 pm

In my area of upstate NY we have a very strong locally run Medicaid managed care program. I don't think getting care is a problem at all around here. We are in an area that's large for this region. Plenty of docs to see. Most hospitals own medical practices and all of those accept Medicaid.

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Pajamas
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Re: NYS medicaid Pre 65 - no asset test?

Post by Pajamas » Mon Mar 27, 2017 8:37 pm

Yes, that's correct, no asset test in NY for Medicaid for those under 65. Basic dental and vision coverage is also included in the Medicaid as well as medical transportation.

When he turns 65, Medicaid will impose a resource test so he will switch to Medicare.

Medicaid in New York used to basically cover everything at no charge at any provider accepting Medicaid. Now he will have to join a managed care plan and use their network and there are small copays for services ($3 for doctor visits, $1 for generic meds), but the copay must be waived if the patient can't pay it.

He could have a Modified Adjusted Gross Income of up to $23,760 for 2017 (200% of Federal Poverty Level) as a single individual and qualify for NY's Essential Plan, which is very similar to Medicaid except that it costs $20 a month and has copays of $25 for basic services but no deductible and a low annual out-of-pocket limit.

littlebird
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Re: NYS medicaid Pre 65 - no asset test?

Post by littlebird » Tue Mar 28, 2017 7:52 pm

drawpoker wrote:
littlebird wrote:
drawpoker wrote:Also, with a projected income that low, he will also be eligible for the energy assistance program.
They don't count assets either. Just goes strictly by whatever monthly income you had in the 30 day period prior to putting in application.

He will get considerable help to pay for both winter heating and summer a/c bills.
Even if he lives in a McMansion :wink:
This kind of help is extremely limited.
In New York? If he was in Maryland, same circumstances, same income, he would be in line for around $550-$750 every year (depending on what fuel he uses for winter heating) NY, being an even higher cost of living area, would likely be more. Nothing to sneeze at :D
This is the sense in which I meant that it's limited (block grant; not entitlement):

If you need help with your heating bill, or if you know someone who does, HEAP can help. HEAP is a federally funded program that provides assistance to eligible customers to pay their home heating bills. Customers are encouraged to apply as soon as possible for assistance, as funds are limited and will be distributed on a first-come, first-served basis. Regular HEAP closed March 17th and Emergency HEAP will close on March 31st.

Grant amounts vary and will be provided only while HEAP funding remains available. Additional assistance may be available for those with a heating emergency. The maximum Regular HEAP grant for customers that use natural gas to heat their home is $401.

I don't believe it covers A.C. costs in N.Y.

drawpoker
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Re: NYS medicaid Pre 65 - no asset test?

Post by drawpoker » Wed Mar 29, 2017 8:23 pm

Yes, but there are two (2) components to the energy assistance available to certain low-income households.

The federal portion, as you cited, which is primarily intended for the heating season, is indeed part of a block grant to the states, and carries the warning when the money runs out, that's it.

What you are overlooking is that there is a separate grant available to electric customers to help pay bills in the summer months that nearly all states have on the books

In Maryland it is called EUSP - not sure about NY (or AZ) but surely they have something similar.

http://dhr.maryland.gov/office-of-home-energy-programs/

When I quoted $550-$750 as likely amount the OP will get I meant as a total grant coming from both of these programs.

It could be higher.

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