This article was updated 02/15/2023.
As of January 2023, the income and resource limits for people with a disability and adults over age 65 increased significantly. This means that many New Yorkers may no longer have excess income, or their excess income may decrease. On February 10, 2023, New York State Department of Health further increased the income and resource limits based on the 2023 Federal Poverty Levels (FPL).
Here is a sample notice that Medicaid is sending to current Medicaid recipients with a spend-down informing them of these changes. See GIS 23 MA-02 and GIS 22 MA/11 for more information.
What are the new limits for 2023?
The income eligibility will be raised to 138% of the Federal Poverty Level and the resource limits are also increasing by nearly 50% for individual applicants and married couples who are both receiving Medicaid services. These increases to the financial limits will improve access to services for Medicaid recipients and those seeking Community Medicaid for home care services.
2023 Medicaid Limits for Aged, Blind and Disabled*:
Individual Applicant
Income = $1,677/month (+$20)
Resources = $30,182
Married Couple (who are both receiving care)
Income = $2,268/mth (+$20)
Resources = $40,821 combined
Community Spouse Allowance
Income = $3,715.50/mth
Resources = $74,820 minimum resource allowance
*Limits updated 2/10/2023 to reflect 2023 Federal Poverty Levels
Can I still spend-down if my income is too high?
Yes, if your income is still above the limits even with these adjustments, you can continue to deposit that money into your pooled trust to maintain eligibility.
You can also choose to spend-down your excess income by paying that money towards qualified medical expenses to lower your monthly income. Please note, this means that you will not be eligible for Medicaid services until you have paid enough medical expenses for that month. So, this is generally not the best solution for a person who requires daily home care services.
What do I deposit into my pooled trust?
Contact Medicaid to Recalculate Your Spend-down
After January 1, 2023, current Medicaid recipients with a spend-down can contact the Local Department of Social Services or HRA office to report income changes and request a recalculation of your spend-down.
Medicaid will inevitably be inundated with these requests, so you may need to make multiple attempts to contact them. NYSARC cannot assist you in determining your new spend-down amount. If you need assistance, we recommend you contact a trusted professional who can provide you with a conservative estimate of your new spend-down using the limits for 2023.
Wait Until Your Next Renewal
Alternatively, you can wait until your next renewal and Medicaid will re-budget your spend-down at that time under the new limits. Deposits made to your trust account before the spend-down is decreased are not refundable and could mean you are paying higher administrative fees.
If Your Spend-down Amount Changes
Notify NYSARC immediately to update your deposit amount and associated monthly fees, as applicable. Submit the appropriate forms to makes any changes to your scheduled monthly deposits and/or automatic payments. Download the forms.
If you have any questions, please contact customer service at (518) 439-8323.