New York State Community Medicaid

Unitedhealthcare Connected For Mycare Ohio

UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

Preserving Medicaid Eligibility While Protecting Your Assets Trusts

Planning for the financial demands of aging in America is a necessity if you want to avoid spending away all your savings and property to pay for the care of a loved one. Expenses for long-term nursing care, at home or in an institutional setting, will drain financial resources quickly. Unless you purchased a private long-term-care insurance policy or have unlimited funds, Medicaid is the last best option to meet uncovered healthcare expenses.

Ely J. Rosenzveig and Associates specializes in the protection of your financial assets while preserving your eligibility for Medicaid coverage. Among the most effective instruments the law provides to protect assets from Medicaid and from estate taxes is a trust.

Transferring assets into a Medicaid Asset Protection Trust in advance of when Medicaid may be needed permits the trust creator to preserve income producing assets and property for their own or someone elses benefit. By transferring title to the trust, the asset is no longer owned by the Medicaid applicant or their spouse and is not counted by Medicaid to disqualify the donors from coverage.

At Ely J. Rosenzveig and Associates, we can help you find the right trust for your life and circumstances.

Contact our experienced elder law and trusts & estates attorneys at Ely J. Rosenzveig and Associates to learn more about how you can retain your financial assets and still qualify for both NY Chronic Medicaid and Community Medicaid.

Call Ely J. Rosenzveig and Associates today:

Webinars On Medicaid Eligibility And 2023 Changes

• Medicaid Part 2: Myths and Facts Liens, Lookback, IRAs, and More with NYLAGs Rebecca Wallach and Anna Arellano

Meanwhile the current rules in 2022:

• Individuals who are under age 65 and who do not receive Medicare – known as MAGI MEDICAID — they have:

• No limit on resources or assets .

• Higher income limits compared to age 65+ and disabled individuals . . Also, their income is counted differently than for Disabled, Aged, and Blind or DAB budgeting. They use “MAGI” budgeting.

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Is Your Home Safe From Medicaid Spend Down Requirements

Among the most effective instruments the law provides to protect assets from Medicaid and from estate taxes is a trust.

Chronic Medicaid covers extremely expensive full-time institutional nursing home care and can require an applicant to sell their home, and spend down their financial resources, until they meet the programs financial eligibility levels. If a spouse or minor child, or a disabled or caretaker child resides in the house, or if the applicant intends to return home, the house would be exempt from Medicaid imposition, and would not be counted as an available resource for Medicaid. Otherwise, it is available for Medicaid spend down before a Medicaid applicant could begin coverage.

If the Chronic Medicaid applicants home is exempt based on a spouse or child living there, the death of the last qualifying resident can open the home up to a Medicaid claim for reimbursement.

Community Medicaid, on the other hand, exempts up to $955,000 of the applicants home value and does not count it as an available resource.

In either case, transferring the home to one of several possible trusts will eliminate it from Medicaids reach if it is done before the 5-year look-back period for Chronic/Institutional Medicaid coverage, or up to a two and a half year look back period for Community Medicaid .

Dual Special Needs Plans In 2022

New Yorkers on a UnitedHealthcare Dual Special Needs Plan get many extra benefits beyond those you get with either Original Medicare or Medicaid.

• Dental coverage Up to $1,000 for covered dental such as certain exams, cleanings and fillings
• Prescription drug coverage $0 copay on covered generic and brand-name prescriptions including home delivery
• OTC+ Health Food $50 a month on a prepaid card for OTC and covered groceries in-store or online
• Renew Active® A fitness program for body and mind, at no additional cost

• NY Dual Special Needs Plan

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Healthy Rewards In Blue Cross Blue Shield Medicaid:

Healthy Rewards is a no-cost, and optional program for eligible members enrolled in health plan. Empire blue cross blue shield Medicaid program encourage members to get the care , improve their health and also create a healthy lifestyle.

Members redeem these Healthy Rewards through the Benefit Reward Hub:

• Get up to $40 for high blood pressure medication refills
• Get $50 for a diabetic retinal eye exam
• Get $5 for completing a What do you know about diabetes? quiz
• Get up to $50 for viral load tests with their HIV care team
• Get $50 for spirometry testing for COPD
• Get $50 for a breast cancer screening
• Get $50 for a colorectal cancer screening
• Get $25 for a cervical cancer screening
• Get $25 for a chlamydia screening
• Get $25 for a follow-up visit with their provider within 7 days of a behavioral health hospitalization
• Get $25 for yearly well-child visits
• Get $25 for yearly childhood dental visits
• Get $25 for Combo 2 adolescent immunizations
• Get $25 for Combo 3 childhood immunizations
• Get up to $40 for ADHD medication refills
• Get $25 for pregnant members who go to a prenatal visit in their first trimester, or within 42 days of joining our plan
• Get $50 for a postpartum visit within 7-84 days of delivering their baby
• Get $50 for six well-baby visits within the first 15 months of life
• Get up to $40 for two well-baby visits between 15 and 30 months of life

Please visit Benefit Reward Hub to redeem Healthy Rewards.

How The Ny States Lookback Law Works

• You will not be subject to this new Lookback Law and will not incur transfer penalties if you file an application prior to the October start date.
• After October 1, 2022, you and your spouse* will be required to supply any and all financial records during the designated lookback period.
• *This is true whether or not your spouse needs Medicaid services. Also, even if your spouse refuses to comply, it is still required.
• The lookback time frame is set to eventually increase from the initial 15 months up to 30 months and refers to the months preceding your application.
• Asset transfers that take place during the lookback months prior to your application will signal the need for a review. The review will look at transfers that are below fair market value.

• Assets that have been transferred below a fair market value within the lookback time frame could deem you ineligible for home care or community-based Medicaid benefits and/or incur transfer penalties.
• Payment for Community Medicaid or long-term home care may be denied depending on the cash value of your transfers. If below fair market value, the cash values of these transfers will be used to establish how many months of payment will be denied by Medicaid.

For the latest information and updates on this NY law, please visit the government website.

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What Are The Eligibility Requirements For Community Medicaid In New York

Since Community Medicaid is a means-tested program, there are specific requirements that must be met in order to qualify for benefits. Firstly, an individual must be aged 65 or older or disabled. There must also be an established need for services. Prior to 2021, an applicant needed to show that they need assistance with at least two activities of daily living .

As of July 1, 2021, applicants must show a need for assistance with a minimum of three ADLs. If the individual has an Alzheimers or dementia diagnosis, the applicant needs to show they need help with more than one ADL. These ADLs include:

• Bed mobility turn and position

There are also personal care tasks that may be factored in when determining eligibility. Examples of Level II personal care tasks include:

• Administration of medications
• Preparation of meals with modified diets
• Providing routine skincare
• Changing of simple dressings

Also, recipients need to be financially eligible. In order to determine someones eligibility, there is an assessment of the applicants income as well as assets. The state will review two categories within the applicants financials including their income and applicable resources.

In this case, income is considered as any monies generated regardless of the source. This income can include Social Security, wages, pensions, alimony, IRA in distribution, or gifts.

When Does This New Lookback Law Go Into Effect

Although this law was first enacted in April 2020, the effective date was postponed several times. The initial date is now proposed to begin implementation on January 1, 2022. This means that Medicaid home care applications beginning on that date, will be subject to a 15-month lookback.

Therefore, beginning January 2022, applications will require records that date back to October 1, 2020. So, any assets that have been transferred from October 1, 2020, forward, will be included in the initial lookback period. Applicants who submit Medicaid applications before January 1, 2022, wont be subject to this lookback and not incur transfer penalties.

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Northwell Opens Two Multidisciplinary Practices In Suffolk County

Northwell Health Physician Partners has opened practices in Setauket and Port Jefferson, Long Island, in a project that costs more than $2 million total, the health system announced Thursday.

The Setauket office at 3 Technology Drive cost $1.8 million to open, according to Northwell, and its 6,240 square feet of space will offer internal medicine and urology services. Eight physicians and 14 additional employees will staff the clinic, Northwell said.

In Port Jefferson, a $500,000, 5,635-square-foot office at 815 Hallock Ave. will offer patients breast surgery, cardiovascular care, nephrology and neurology services, neurosurgery, obstetrics and gynecology care and plastic and reconstructive surgery. The location will employ 18 physicians and 16 staff members, Northwell said.

The practices will support continuing care for patients who receive services at nearby Mather Hospital in Port Jefferson, the health system said.

These state-of-the-art facilities allow us to bring new and expanded services to this growing community and support the strategic growth at Mather Hospital, Joseph Baglio, senior vice president and ambulatory operations officer for Northwell Healths Eastern region, said in a news release.

Northwell recently opened a more than 25,000-square-foot facility in Bay Shore.

Advocates Fear The New York Independent Assessor Medicaid Program Will Lead To Denials Delays

The state Health Departments Independent Assessor program began conducting assessments for Medicaid patients who have an immediate need for personal care services or consumer-directed personal assistance services Thursday, after the programs initial rollout in May. Advocates who work with older New Yorkers, those with disabilities and those who are chronically ill say they are concerned the program is creating care delays or causing patients to get lost when trying to get the home care they need.

Prior to May, people on mainstream managed care Medicaid who wanted home care services went through their plan. New Yorkers who wanted to enroll in managed long-term-care plans, which are for people with disabilities or illnesses who need sustained help with activities of daily living such as cooking and bathing, went through the Conflict Free Evaluation and Enrollment Center program to determine their eligibility. The CFEEC was run by Maximus Health Services, a national company that works with local governments.

According to the Health Department, the NYIA program was created because of statutory, regulatory and administrative reforms included in the 2020-2021 state budget and regulatory amendments.

Providers say clinical assessments done over telehealth also present barriers to getting home care.

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Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

What Is The Eligibility For Pregnancy Medicaid In Florida

A pregnant woman may qualify for Medicaid if her familys countable income does not exceed income limits.

For pregnant women who do not meet the citizenship requirements for Medicaid, there is Emergency Medical Assistance for Non-Citizens.

Furthermore, you can get Presumptively Eligible Pregnant Women , which is temporary coverage for prenatal care only.

During the temporary coverage period, while you are on PEPW, you will have to submit an application to determine if you can continue to receive Medicaid benefits during your pregnancy.

Additionally, women with family income over the limit for Medicaid may qualify for the Medically Needy Program.

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Early Planning Is Key To Getting Medicaid When You Need It

At Landskind & Ricaforte Law Group, P.C., we know the difference Medicaid benefits can make to people who need care as soon as possible. We guide you through all steps of the process, getting you the care you need without sacrificing your loved ones’ inheritances. Call us today at 333-5007 or contact us through our online form to learn how we can be of assistance.

Understanding Ny States New Medicaid Lookback Law

Latest update: As of July 14, 2022, although the new NY State Lookback was originally slated to go into effect in 2020, this date has been pushed to October 1, 2022. Community-based Medicaid Applicants and their spouses will be required to provide financial records/transactions that took place within the lookback period for up to 30 months.

So, if you need Community Medicaid or are looking to receive long-term home care benefits, you should start the process as soon as possible. Starting on October 1, 2022, applicants for community-based or home care Medicaid benefits will find the process to be more complicated due to the Medicaid Lookback Law in New York State.

Applying early will avoid being subject to this new law that can make you ineligible or result in penalties. This article will help explain why.

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Are There Any Exceptions To The Law

Yes, there are exceptions to the new lookback law. Transfers to an applicants spouse or to a blind or disable child are exempt. Remember, too, that transfers of assets that occur prior to October 1, 2020, will not be subject to a penalty.

Also, transfers to a supplemental needs trust for those disabled individuals under 65 are exempt. In addition, some exempt assets such as Holocaust restitution would not incur a penalty.

Overview Of The Difference Chronic Vs Community Medicaid

Applying for Medicaid in New York can be confusing because of the numerous programs. The two most confused programs are Chronic Medicaid and Community Medicaid. Each program implements different eligibility criteria and offers different coverage.

The Chronic Medicaid program handles the claims for people who need chronic or long-term institutional care in facilities like nursing homes and other hospital-like settings. Chronic Medicaid is sometimes referred to as Institutional Medicaid.

Community Medicaid is the program that manages claims for healthcare and related services provided to people at home or in other community settings, including needs for long-term community-based care, adult day healthcare, some assisted-living centers, personal care aides to help with activities of daily living, and skilled visiting nurses.

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Ny Medicaid Income Limits And Financial Resource Caps

The Medicaid program pays for the high costs of institutional and long-term nursing home care and for a multitude of at-home or assisted living facility services and expenses. Because of the mounting expense of healthcare services for elders, aged 65 and older, and disabled residents, eligibility for Medicaid health insurance coverage is restricted by income and asset caps, as well as look-back periods for transfers of assets.

Working with an experienced elder-law attorney at Ely J. Rosenzveig & Associates can, with the proper planning, ensure access to Medicaid coverage even for those whose income and resources exceed the Medicaid eligibility caps.

2022 Income and Resource Limits for Chronic and Community Medicaid: The eligibility rules for New York Chronic Medicaid and Community Medicaid include the following income and financial resource limits:

• Monthly Income Limits

• $1,637 for a married couple, both spouses applying for Medicaid coverage

• $934 for a married applicant where only one spouse is applying for Medicaid coverage

• $24,000 for a married couple, both spouses applying for Medicaid coverage

• $16,000 for married applicant spouse and $137,400 for non-applicant spouse