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Neighborhood
Legal Services, Inc.
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Neighborhood
Legal Services, Inc.
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MEDICAID FINANCIAL ELIGIBILITY LEVELS FOR NEW YORK
EFFECTIVE JANUARY 1, 2005
All figures are net income levels per month after exemptions and disregards.
Resources are counted as of the first of the month.
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PUBLIC ASSISTANCE (PA) STANDARD OF NEED
Use this section for Low Income Families with Children (LIF) and Single Individuals and
Childless Couples (S/CC) Categories
FAMILY SIZE |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
FOR EA. ADD’L MEMBER ADD: |
| 1. MAX. GROSS INCOME TEST (185% OF PA STANDARD ) | $ 566 | $ 776 | $ 936 | $1127 | $ 1326 | $ 1474 | $1628 | $ 1811 |
|
| 2. MAX. PA GRANT (STANDARD OF NEED) |
$ 306 | $ 419 | $ 506 | $ 609 | $ 717 | $ 797 | $ 880 | $ 979 |
72.50 |
| 3. RESOURCE TESTS FOR LIF LOW INCOME FAMILIES $3,000 AND __________________________________________________________ S /CC CATEGORIES SINGLE INDIVIDUALS AND CHILDLESS COUPLES $2,000 60 YEARS AND OVER $3,000 |
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REGULAR MEDICAID ELIGIBILITY MONTHLY INCOME AND RESOURCE LEVELS
Use this section for ADC-related families and SSI related individuals
Number in Family |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
Each Additional Person |
INCOME |
667 |
975 |
984 |
992 |
1,000 |
1,134 |
1,275 |
1,417 |
+142 |
| RESOURCES | 4,000 |
5,850 |
5,900 |
5,950 |
6,000 |
6,800 |
7,650 |
8,500 |
+850 |
EXPANDED MEDICAID MONTHLY INCOME ELIGIBILITY LEVELS (No Resource Test)
Number in Family |
|
|
|
|
|
|
|
|
Each Additional Person |
200% 2005 FPL |
1,587 |
2,130 |
2,674 |
3,217 |
3.760 |
4,304 |
4,847 |
5,390 |
+544 |
| 133% 2005 FPL for children 1-19 |
1056 | 1,417 | 1,778 | 2,140 | 2,501 | 2,862 | 3,224 | 3,585 | + 362 |
| 100% 2005 FPL for pregnant women* full coverage) |
794 | 1,065 | 1,337 | 1,609 | 1880 | 2,152 | 2,424 | 2,695 | +272 |
