2022 NYS INCOME AND RESOURCE STANDARDS AND FEDERAL POVERTY LEVELS (FPL) FOR MEDICAID AND OTHER PROGRAMS

Reference Documents: GIS: 22/MA 01, 21/MA 26, 21/MA 25, WLM 2022-00022, 2021-00277, 2021-00054, and NYS Partnership for Long-Term Care.

MAPDR-01 03/16/2022

(Obsoletes MAPDR-71)

1.                      Non-MAGI Medicaid Levels (SSI and SSI-Related Consumers With or Without A Surplus)

1

2

3

4

5

6

7

8

9

10

Income

1

2

3

4

5

6

7

8

9

10

Level

(Inst Spouse) – $50

(Inst Spouse) – $16,800

$763 is the maximum monthly family member allowance

Qualified Partnership Policy Holder (QPP) Medicaid Extended Coverage (MEC) Asset Disregards for Total Asset Policy Holders/Dollar-for-Dollar Asset Protection Plan Policy Holders

(Maximum)

Increased to $1,717.50 for QPP’s

Increased to $3,435. 00 for QPP’s

Family Size

1

2

Monthly Income

250% FPL

$2,832

$3,815

Resources

$20,000

$30,000

Family Size

1

2

3

4

5

6

(Childbearing Age)

$2,526

$3,403

$4,280

$5,157

$6,035

$6,912

$878

$499.00 (Less than 30 Quarters)

Medicare Part B Premium: (Rates based upon 2020 income tax filings)

·  The Cost of Living adjustment (COLA) for Social Security will be 5.9% percent for 2022.

·  The standard monthly premium for Medicare Part B enrollees is $170.10 for 2022. Most Medicare beneficiaries will pay this amount. The standard Medicare Part B $170.10 monthly premium is for beneficiaries with income less than or equal to $91,000. Due to the SSA 5.9% COLA, some beneficiaries who were held harmless against Part B premium increases in 2021 will pay the full monthly premium of $170.10 in 2022. This is because the increase in their Social Security benefits will be greater than or equal to the increase in their Part B premium.

Under federal law commonly known as the “hold harmless” provision, Medicare Part B premiums cannot raise more than the COLA in any year for most consumers. However, this provision does not apply to the consumers listed below. Their Part B premium increase is currently $170.10 in 2022.

·   Individuals whose income is above $91,000, or a married individual when the couple’s combined income is over $182,000, will pay the standard premium and an Income Related Monthly Adjustment Amount (IRMAA);

·   Beneficiaries who do not receive Social Security benefits;

·   Individuals who are directly billed for the Part B premium;

·   New Medicare Part B beneficiaries; and

·   Individuals who have Medicare and Medicaid, and Medicaid pays the premiums.

Standard Allocation: From non-SSI-related parent to non-SSI- related child

$433.00

PASS-THROUGH FACTORS: .972 and.139

Note: Budgets with a “From” date of January 1, 2021, or later, that utilize a Federal Poverty Level (FPL) must be calculated with the 2021 Social Security benefit amount and Medicare Part B premium amount until the 2022 FPLs are available on MBL. The 2021 Social Security amounts and Part B premium must be used until Phase Two of the Mass Re-budgeting.

of 2

QMB 100% FPL

SLIMB 120% FPL

QI-1 135% FPL

(185% FPL)

NO RESOURCE TEST FOR ANY MSP PROGRAM

9.        Monthly Regional Nursing Home Rates (Use the rate for the region in which the facility is located)

Putnam, Rockland, Sullivan, Ulster, Westchester

10. Fair Market Regional Rates (Averages) / Special Standards for Housing Expenses

11.                                                     MAGI Levels for Medicaid and Related Program Eligibility

Family Size

1

2

3

4

5

6

7

8

9

10

Add’l Person

$2,526

$3,403

$4,280

$5,157

$6,035

$6,912

$7,789

$8,666

$9,543

$10,420

$878

$2,526

$3,403

$4,280

$5,157

$6,035

$6,912

$7,789

$8,666

$9,543

$10,420

$878

154% FPL

$1,745

$2,350

$2,956

$3,562

$4,167

$4,773

$5,379

$5,985

$6,590

$7,196

$606

110% FPL

$1,246

$1,679

$2,112

$2,544

$2,977

$3,410

$3,842

4,275

$4,708

$5,140

$433

$1,745

$2,350

$2,956

$3,562

$4,167

$4,773

$5,379

$5,985

$6,590

$7,196

$606

138% FPL

$1,563

$2,106

$2,649

$3,192

$3,735

$4,277

$4,820

$5,363

$5,906

$6,449

$543

$1,563

$2,106

$2,649

$3,192

$3,735

$4,277

$4,820

$5,363

$5,906

$6,449

$543

$1,756

$2,366

$2,975

$3,585

$4,195

$4,804

$5,414

$6,024

$6,633

$7,243

$610

$1,133

$1,526

$1,920

$2,313

$2,706

$3,100

$3,493

$3,886

$4,280

$4,673

$394

$1,563

$2,106

$2,649

$3,192

$3,735

$4,277

$4,820

$5,363

$5,906

$6,449

$543

Family Size

1

2

3

4

5

6

7

8

$2,526

$3,403

$4,280

$5,157

$6,035

$6,912

$7,789

$8,666

$878

Premium Categories

1

2

3

4

5

6

Person

Free Insurance (under 160% FPL)

$1,811

$2,441

$3,070

$3,699

$4,329

$4,958

$629

(Max. $27 per family) (160% – 222% FPL)

$2,515

$3,388

$4,261

$5,134

$6,007

$6,881

$874

(Max $45/family) (223% – 250% FPL)

$2,832

$3,815

$4,798

$5,782

$6,765

$7,748

$984

(Max. $90 per family) (251% – 300% FPL)

$3,398

$4,578

$5,758

$6,938

$8,118

$9,298

$1,180

(Max. $135 per family) (301% – 350% FPL)

$3,964

$5,341

$6,718

$8,094

$9,471

$10,848

$1,377

(Max. $180 per family) (351%-400% FPL)

$4,530

$6,104

$7,677

$9,250

$10,824

$12,397

$1,574

FPL (Premium amount varies from plan to plan)

$4,530

$6,104

$7,677

$9,250

$10,824

$12,397

$433.00

$433.00

Nassau, Suffolk, Westchester and

Rockland