Beginning January 1, 2023 Medicaid eligibility guidelines for people 65 and over and people with disabilities will be increasing to 138% of the Federal Poverty Level (FPL). This will result in the income and asset limits to increase:
- Income Limits:
- Single- increase from $934/month to $1,563/month
- Couple- increase from $1,367/month to $2,106/month
- Please note the above limits are based on 2022 Federal Poverty Levels. They will be increased when the FPL is increased in 2023.
- Asset Limits:
- Single- increase from $16,800 to $28,133
- Couple- increase from $24,600 to $37,902
Medicare Savings Program (MSP)
This change is effective with new applicants and requests for redetermination of MSP eligibility received on or after January 1, 2023. Determinations for any period prior to January 1, 2023, must be determined using the 2022 MSP FPL levels.
New FPL levels effective January 1, 2023
Qualified Medicare Beneficiary (QMB): Clients with income less than or equal to 138% of the FPL will be QMB eligible, beginning January 1, 2023. QMB eligible clients may also have active Medicaid coverage. NY Medicaid will pay Medicare Part B premiums, coinsurance, and deductibles for those eligible at the QMB level.
Specified Low Income Medicare Beneficiary (SLMB): This category will no longer be used for new applications or renewals on or after January 1, 2023. Since the SLMB income level is 120% of the FPL, it is being subsumed into the QMB level.
Qualifying Individuals (QI): Clients with income above 138% of the FPL and less than or equal to 186% of the FPL will be QI eligible, beginning January 1, 2023.
|
2023 MSP Income Limits |
|
|
CATEGORY |
INCOME/FPL |
|
QMB |
0% up to and equal to, 138% |
|
SLMB |
Category no longer applicable |
|
QI |
Above 138% and up to and equal to, 138% |
Mass re-budgeting will not occur for those with current MSP coverage. Letters are being sent to these individuals who are MSP eligible, above the 2022 QMB level, advising them that they may be eligible for MSP with benefits not currently available with their current level of coverage. Instructions on where to obtain and submit both the MSP Only and full Medicaid applications will be provided in the letter.
A separate letter with similar information will be sent to those individuals who are eligible for Medicaid with excess income.
***Please stay tuned as more information on these changes becomes available.