Eligibility

Medicaid Eligibility Requirements

(845) 219-5834

Determining Medicaid Eligibility

Medicaid eligibility is determined by your local Medicaid agency. Your eligibility is based on your income and the assets you own, which includes life insurance and any retirement plans. If you are married, any assets in your name, as well as those in joint accounts with your spouse, or those held by your spouse alone, are all taken into consideration. If you need help with the Medicaid process, call Mark G. Aberasturi, Attorney at Law PC at (845) 219-5834.

Medicaid Income Allowances

For 2024, all Medicaid recipients (other than SSI recipients)are entitled to retain up to $16,800 in assets in their name. If you have a spouse, they may retain between $74,820 and $148,620.

If you are unmarried and receive health care in your home, you are also entitled to retain $1,677 of monthly income. Married couples who apply for home care together are allowed up to $2,268 in monthly income. Individuals, married, or singles receiving skilled nursing care are allowed only $50 per month, as a personal needs allowance. Your spouse may retain up to $3,715 of monthly income.

Assets Not Considered

When your local Medicaid agency is determining the eligibility of you or your spouse, certain assets will not be considered. These assets include your primary residence (in certain circumstances), the contents of your household, one vehicle, a prepaid irrevocable funeral contract, and any other necessary items.

What to Do When You Are Denied Coverage?

If you feel that you have been wrongly denied eligibility for Medicaid benefits, you have options. The Medicaid system provides you with an appeals process. During this process, you may submit any additional documentation you may have and request a reconsideration. You may also file for a "Fair Hearing" at this time. You may also commence a court proceeding to enforce your rights.

This process can be complex and has strict time frames. Contact Mark G. Aberasturi, Attorney at Law PC to appeal a Medicaid determination. Mark has over 30 years of experience ensuring people obtain the benefits they are entitled to.