More Medicaid Changes: Finally Some Good News

November 10, 2011

Author: Trilby de Jung

The last issue of the LSJ shared not such good news about changes to Medicaid – (reductions in services, expansions in mandatory Medicaid managed care).  In this issue we have two positive developments worth highlighting:

• Children ages 6-18 are now eligible for Medicaid at the same income level as younger children – 133% of the federal poverty limit.  This change should reduce the need for families to move their children between Medicaid and Child Health Plus after their sixth birthday, and is viewed by many as a step in the direction of the simplifications required by the Affordable Care Act.  For the administrative directive announcing this change, which took effect on November 1, 2011, visit:  http://www.health.ny.gov/health_care/medicaid/publications/docs/gis/11ma021.pdf

• Medicaid recipients receiving Social Security as their only source of income will not need to renew their Medicaid cases, if their resources were below 85% of the Medicaid resource level at the last renewal or at application, whichever was later (the Medicaid resource level is $13,800 for a single person and $20,100 for a couple).   These SSI-related recipients should receive a notice informing them that their Medicaid coverage will continue unchanged and explaining that they do not need to respond to the mailing unless they have change to report in income, resources, health insurance or residence.  

This change is described as a proposal submitted to the Medicaid Redesign Team and chosen for implementation to reduce costs and improve quality in New York’s Medicaid program.  It takes effect in December, 2011 in New York City and in January , 2012 upstate.  For details see the Administrative Directive at this link: http://www.health.ny.gov/health_care/medicaid/publications/docs/adm/11adm9.pdf