New York State Announces 2025 Medicaid Income and Asset Levels
01/24/2025The 2025 Cost-of-Living Adjustment (COLA) for Social Security is 2.5%
- The standard monthly premium for Medicare Part B enrollees will be $185 for 2025
- Medicare Part A Hospital deductible is $1,676 for 2025 (The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.)
- Medicare Part A coinsurance of $419 per day for day 61 through 90 in a benefit period and $838 a day for lifetime reserve days.
- Skilled Nursing Facility Co-insurance $209.50 for rehab days 21-100 if the patient qualifies for rehab services. There is no coinsurance for the first 20 days of a qualified stay.
- Medicaid Resource Level for an individual $31,175
- Medicaid Resource Level for a married couple $42,312
- The Medicaid Monthly Income Level for an individual is $1,799.75
- The Medicaid Monthly Income Level for a married couple is $2,432.25
- Surplus Income for Community Medicaid (Home Care) can be directed to a pooled income trust
- Net Available Monthly Income (NAMI) for Institutional Care goes to the Nursing Home over $50
- The SSI federal benefit for an individual living alone is $967 and $1450 for a married couple
- The SSI resource levels remain $2,000 for individuals and $3,000 for couples.
- The Maximum federal Community Spouse Resource Allowance is $157,920.00.
- The community spouse Maximum Monthly Maintenance Needs Allowance (MMMNA) is $3,948.00.
- The home equity limit for Medicaid coverage of nursing facility services and community-based long-term care is $1,097,000.00.
Veterans Benefits:
- The net worth limit to be eligible for Veterans Pension Benefits is $159,240.
Example of net worth calculation:
Veteran has $100,000 in assets and $21,000 in annual income for VA purposes. This Veteran has a net worth of $121,000. This is less than the net worth limit of $159,240. Thus, this Veteran is eligible for Veteran’s Pension benefits.
- The 2025 Veteran’s Aid and Attendance Pension Benefit is:
- Single: $2,358.00 a month or $28,300 annual
- 1 Dependent (Spouse or Child) $2,795.00 a month or $33,548 annual
- Dependency and Indemnity Compensation (DIC) rates for the surviving spouse and dependent children of Veterans *Please note that these survivor benefits are tax exempt and Aide and Attendance is a income disregard for Community Medicaid.
- Surviving Spouse of a Veteran $1,653.07 or $19,836.84 annual
- Aide and Attendance $409.53
- Housebound Allowance $191.85
- Transitional benefit $350 for the first 2 years after the veterans death
- Children under 18 years of age $409.53 for each eligible child
Period and Lookback for Veterans Benefits:
- There is a three (3) year lookback for transfers of assets.
- A penalty period is a length of time when a Veteran is not eligible for pension benefits because he/she transferred assets for less than fair market value during the lookback period which is a financial review of the 36 months (3 years) preceding the application. The Veterans Administration will not pay pension benefits during a penalty period.
- The penalty period rate in 2024 is $2,727.
New York State’s Community Medicaid program provides additional health insurance to qualified individuals who plan to age in place but need assistance paying for care at home. This program is for individuals who need help with activities of daily living such as: bathing, dressing, toileting, meal preparation, transferring, mobility and personal hygiene. There is a plan to initiate a 30-month look-back for Community Medicaid applicants which has been delayed several times. At the present time, New York has not implemented a look-back period for Community Medicaid and has not released a date when this change will begin.
* New York is a Maximum State
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