Home Care with Community Medicaid

Home care paid for by New York State is known as “Community Medicaid”. Paying your own living expenses, plus the cost of caregiving services, is beyond the means of many.

Since 2020, there have been numerous attempts to create a new thirty month look-back period for Community Medicaid eligibility. So far, none of these attempts have been successful and now 2024 is the earliest expected date for implementation. There is no current look-back period for Community Medicaid in New York. This means that you may move assets out of your name this month and obtain Medicaid home care benefits next month, provided you need the care.

Currently, an individual may keep about $1,700 per month plus the amount of any health care insurance premiums. Any excess income must be used towards their care. What if your living expenses exceed $1,700 per month? Enter the “pooled income trust”.

Certified by the state, pooled income trusts are used to allow you to send your excess income, i.e. the amount over the $1,700 per month you are allowed to keep, to the trust along with copies of your bills for food, rent, mortgage, utilities, home repairs, etc. The trust pays your bills and any amounts unused will accumulate in your account and eventually be added to the “pool” to be used for charitable purposes after your death. Any monies paid to the pooled income trust are not counted as income for Medicaid purposes, allowing you to qualify for Community Medicaid.

The number of hours you will receive depends on the county’s assessment of your needs regarding the activities of daily living (ADL’s). Some of these are eating, bathing, shopping, cooking, personal hygiene, ambulating, housekeeping, dressing, etc.

Several non-profit organizations exist that offer pooled trusts. Applying to join is a formal process with which the elder law firm will assist. Costs generally include minimal start-up fees, an initial deposit and reasonable maintenance fees.