New York fully expanded Medicaid under the Affordable Care Act effective January 1, 2014, covering adults 19-64 with income up to 138% of the Federal Poverty Level and no asset test. That expansion pathway is completely separate from long-term-care Medicaid for seniors, which is asset-tested and covers nursing home care, Managed Long Term Care (MLTC), the Assisted Living Program (ALP) and HCBS waiver services.
Two different Medicaid programs, same name
ACA expansion Medicaid uses MAGI-based income rules and no resource test, and is aimed at adults under 65. Long-term-care Medicaid for seniors uses a non-MAGI, asset-tested eligibility path, with 2026 figures including a Community Spouse Resource Allowance of $74,820 to $162,660, a Minimum Monthly Maintenance Needs Allowance of $4,066.50/month, and an SSI resource level of $2,000 for an individual.
A senior applying for nursing home or MLTC-based Medicaid is not applying through the ACA expansion pathway, even though both technically fall under “New York Medicaid.” Confirm which pathway applies with your county's Office for the Aging or an elder law attorney.
