New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter B - Public Assistance
Article 2 - Determination of Eligibility-Categorical
Part 360 - MEDICAL ASSISTANCE
Subpart 360-4 - Financial Eligibility
Section 360-4.7 - Standard exemptions

Universal Citation: 18 NY Comp Codes Rules and Regs § 360-4.7

Current through Register Vol. 46, No. 39, September 25, 2024

(a) Resources.

All resources available to the household of a pregnant woman, an infant younger than one year of age, a child at least one year of age but younger than six years of age whose household income does not exceed 133 percent of the applicable Federal poverty line set forth in section 360-4.7(b) of this Subpart, or a child born after September 30, 1983 who is at least six years of age but younger than 19 years of age and whose household income does not exceed 100 percent of the applicable Federal poverty line set forth in section 360-4.7(b) of this Subpart, are exempt from consideration in determining whether such pregnant woman, infant, or child is medically needy. The following resources are exempt from consideration in determining whether any other MA applicant/recipient is medically needy:

(1) a homestead which is essential and appropriate to the needs of the household. Homestead is defined in section 360-1.4(f) of this Part.

(i) For persons under 21 years of age and persons ineligible for ADC solely because their income and resources are above eligibility limits, a homestead loses its exempt status if the owner is in a medical facility in permanent absent status, as defined in section 360-1.4(k) of this Part, and no spouse, child under 21 years of age, certified blind or certified disabled child, or other dependent relative is living in the home.

(ii) For persons who are 65 years of age or older, certified blind or certified disabled, a homestead loses its exempt status if the owner moves out of the home without the intent to return, and no spouse, child under 21 years of age, certified blind or certified disabled child, or other dependent relative is living in the home.

(iii) As set forth in section 360-4.4(c)(2) of this Part, transfers of homesteads to certain persons may result in ineligibility for MA coverage of certain care, services, and supplies, including nursing facility services.

(2) essential personal property including but not limited to:

(i) clothing and personal effects;

(ii) household furniture, appliances, and equipment;

(iii) tools and equipment which are necessary for a trade or business; and

(iv) an automobile;

(3) one burial plot or space per household member; and

(4) savings equal to at least one half of the appropriate income exemption allowed.

(b) Income.

(1) After an applicant's/recipient's household size has been determined, all available income identified and all applicable disregards applied, the applicant's/recipient's net available household income will be compared to the appropriate standard, except as provided in paragraphs (2), (3) and (4) of this subdivision. The standard which will be used by the social services district is the MA standard shown on the following schedule, or the public assistance (PA) standard of need, whichever is higher.

Schedule MA-2

Number in Family	1	2	3	4	5	6	7
*Annual	$6,700	$9,700	$9,800	$10,200	$11,900	$13,600	$15,300
**Monthly	559	809	817	850	992	1,134	1,275

* For each additional person after seven add $1,700.

** For each additional person after seven add $142.

(2) The net available household income of a pregnant woman, an infant younger than one year of age, or a child born after September 30, 1983 who is at least six years of age but younger than 19 years of age will be compared to the highest of the following three amounts: the applicable MA standard; the applicable PA standard of need; or, 100 percent of the applicable Federal poverty line, as set forth in the following schedule:

Poverty Lines effective January 1, 1996

Number in Household	1	2	3	4	5	6	7
*Annual	$7,740	$10,360	$12,980	$15,600	$18,220	$20,840	$23,460
**Monthly	645	863	1,081	1,300	1,518	1,736	1,955

* For each additional person after seven add $2,620.

** For each additional person after seven add $218.

(3) If the net available household income of a pregnant woman or infant younger than one year of age exceeds the highest of the three amounts described in paragraph (2) of this subdivision, the social services district will compare it to 185 percent of the applicable Federal poverty line, as set forth in the following schedule:

Poverty Lines effective July 1, 1995

Number in Household	1	2	3	4	5	6	7
*Annual	$ 7,470	$10,030	$12,590	$15,150	$17,710	$20,270	$22,830
**Monthly	622	835	1,049	1,262	1,475	1,689	1,902

* For each additional person after seven add $2,560.

** For each additional person after seven add $213.

185 Percent of Poverty Lines effective January 1, 1995 through June 30, 1995

Number in Household	1	2	3	4	5	6	7
*Annual	$13,912	$18,648	$23,384	$28,120	$32,856	$37,592	$42,328
**Monthly	1,159	1,554	1,948	2,343	2,738	3,132	3,527

* For each additional person after seven add $4,736.

** For each additional person after seven add $394.

185 Percent of Poverty Lines effective January 1, 1996

Number in Household	1	2	3	4	5	6	7
*Annual	$14,319	$19,166	$24,013	$28,860	$33,707	$38,554	$43,401
**Monthly	1,193	1,597	2,001	2,405	2,808	3,212	3,616

* For each additional person after seven add $4,847.

** For each additional person after seven add $403.

(4) The net available household income of a child at least one year of age but younger than six years of age will be compared to the applicable MA standard or the PA standard of need, whichever is higher. If the net available household income of such child exceeds the higher of these two amounts, the social services district will compare it to 133 percent of the applicable Federal poverty line, as set forth in the following schedule:

133 Percent of Poverty Lines effective January 1, 1995 through June 30, 1995

Number in Household	1	2	3	4	5	6	7
*Annual	$10,001	$13,406	$16,811	$20,216	$23,620	$27,025	$30,430
**Monthly	833	1,117	1,400	1,684	1,968	2,252	2,535

* For each additional person after seven add $3,404.

** For each additional person after seven add $283.

133 Percent of Poverty Lines effective January 1, 1996

Number in Household	1	2	3	4	5	6	7
*Annual	$10,294	$13,778	$17,263	$20,748	$24,232	$27,717	$31,201
**Monthly	857	1,148	1,438	1,729	2,019	2,309	2,600

* For each additional person after seven add $3,484.

** For each additional person after seven add $290.

(5) To determine if an individual meets the income requirements to be a specified low income Medicare beneficiary as defined in section 360-7.7(i) of this Subpart, compare the individual's income to 100 percent of the poverty line as defined in paragraph (2) of this subdivision and 120 percent of the poverty line as set forth in the following schedule. The individual's income meets the income requirements if it is greater than 100 percent, but less than 120 percent of the poverty line:

120 Percent of Poverty Lines effective January 1, 1995 through June 30, 1995

Number In Family	1	2
Annual	$ 9,024	$12,096
Monthly	752	1,008

120 Percent of Poverty Lines effective January 1, 1996

Number In Family	1	2
Annual	$ 9,288	$12,432
Monthly	774	1,036

Footnotes

* For each additional person after seven add $1,700.

** For each additional person after seven add $142.

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