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The Medicaid Surplus Income Program

Helping New York Residents Obtain Benefits

Medicaid is a health insurance program designed to benefit the poor, but certain individuals who are considered “too rich” for this helpful program are barely scraping by in reality. In particular, the financial limits of Medicaid can unintentionally isolate struggling residents in New York because of the high cost of living in the city. Luckily, the state of New York has a solution in place.

The Medicaid Excess Income Program, often referred to as the Medicaid Surplus Income Program or Medicaid Spend Down Program, is a system in New York that offers Medicaid coverage to individuals who meet all Medicaid eligibility requirements, but exceed the qualifying income level.

In these situations, an individual must apply for Medicaid. The Human Resources Administration (HRA) will review the application and inform the applicant that their income level is higher than the allowed levels for Medicaid benefits. Accordingly, the applicant may therefore qualify for the Medicaid Surplus Income Program.

This program provides similar coverage to standard Medicaid. However, the applicant must pay all excess income to the HRA. Alternatively, they must present the HRA with paid/unpaid medical bills equal to the monthly surplus amount.

The Express Income Program in Action

The maximum amount of money a New York resident can possess while still qualifying for standard Medicaid is $825 per month of income and $14,850 in total assets. Between housing, groceries, daily expenses, and medical bills, even incomes or assets that exceed this limit can quickly prove insufficient.

If one resident makes $600 per month, for example, and has their medical care covered by Medicaid, they might actually be doing better than someone who makes $1,000 per month and has to handle their own medical expenses. If the person who makes $1,000 can prove that they are spending $101 each month on healthcare, or if they pay that $101 excess into Medicaid, they can also become eligible for the program. Even on months that person does not require healthcare, their payment of excess income may be less than what they would pay for another insurance plan.

Providing Relief in Your Time of Need

Lead Attorney Steven Melnik can help if you are interested in applying for Medicaid but make more than the allowed income level. Although you may qualify under the Medicaid Surplus Income Program, we can also talk to you about other options to address your excess income.

For example, you may be able to enter into the pooled income trust. This is an option available to New Yorkers. It involves paying the excess income into a trust which then dispenses money to you for your necessary expenses.

Making the right choices about your Medicaid coverage is important, particularly if you have assets that need protection or if you make more than the allowed income. At the time of this writing, if you are an individual over the age of 65 and your income is more than $767 per month, you may need to consider the Medicaid Surplus Income Program.

At Melnik Law Group, PLLC, we can explain your options to you and help with your application to ensure you get the coverage you need. Our elder law team represents clients throughout Brooklyn, Manhattan and all of New York City in all areas of elder law.

For qualified assistance with surplus income and Medicaid, contact Attorney Melnik at our New York offices today.

Rockefeller Center 7th Floor 1230 Ave. of the Americas New York, NY 10020

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Melnik Law Group, PLLC - New York Elder Law Attorney
Located at One Rockefeller Plaza, 10th Floor New York, NY 10020 . View Map
Phone: (800) 517-5110