NEW YORK STATE MEDICAID
FINANCIAL THRESHOLD CHECKLIST
AND PENALTY PERIOD CALCULATIONS  --  2005

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B e n e fi t s

Incom e Limit s

RESOU RCE LIMIT

REGI ON

MONTHL Y REGIONA L RATE

Comprehe nsive health care benefits, including coverage for prescriptio n drugs, physician services, hospitals, nursing homes and home care

Communit y spouse allowances when other spouse is institutional ized:

Income: $2,378

Resources: $74,820 or the amount of spousal share, up to $95,100.

Amounts of income and or resources may be able to be increased through a Fair Hearing, Court Order or other forms of Medicaid planning.

Individual: $667.00 + $20*

Couples: $975.00 + $20*

*FIRST $20 INCOME IN ADDITIO N TO THE ALLOW ABLE INCOME IS EXEMPT FOR EACH PERSON AGE 65 OR MORE.

Individ ual:
$4,000.00

Couple s:
$5,850.00

Exemp tions: $1,500 per person for burial fund or unlimit ed amount in irrevoc able pre-need funeral agreem ents; home; car; health insuran ce premiu ms.

Central

Long Island


New York City

Northea stern


North Metrop olitan

Rochest er

Western

 

$5,988

$9,612

$8,870


$6,501

$8,332


$6,981

$6,181

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