The New Regulations Regarding Seniors and Medicare Laws

There have been numerous new regulations that concern seniors and Medicare laws in the wake of COVID-19 and changes to the New York state budget. In this blog, we will be sharing more about the new regulations that you can expect to see rolling out and affecting seniors and Medicare in New York. 

The New Regulations Regarding Seniors and Medicare Laws

The New York State legislature passed the 2020-21 budget on April 3, 2020. Unfortunately, the budget led to serious changes to the Medicaid and Medicare programs that will impact the lives of seniors and individuals who need these services. If you have any questions about the changes below, do not hesitate to reach out. It’s also important to note that things have been changing rapidly as NYS faces two crises in COVID-19 and in the new budget, so information noted below may change in the future. 

  • There will now be a 30-month (2.5 year) look-back period for long-term care services that take place at home starting on October 1, 2020. This means that there will be a full review of a person’s finances over the past 2.5 years if they are looking for Medicaid or Medicare coverage of long-term care services. While this is not as lengthy as the period required for nursing home care (60 months), it might present an additional obstacle to those in need of in-home care services. We anticipate that this look-back period will be similar to the one for nursing home coverage, in that the person seeking coverage must present 2.5 years of financial records to their Local Department of Social Services for processing. 
  • The eligibility requirements for enrolling in the Medicaid Consumer Directed Personal Assistance Program (CDPAP) and Personal Care Services (PCS) have also increased. In the past, the only thing that was required was an assessment to determine if they would require at least 120 consecutive days of care. Now, seniors will need to require, at a minimum, limited assistance with two or more activities of daily living. There is an exemption for individuals who have been diagnosed with dementia or Alzheimer’s. 
  • Spousal impoverishment rules will stay the same for anyone looking for coverage of long-term services. The first budget talks discussed changes to this rule, but it has not changed. 
  • Spousal refusal is also still available to any community spouse who cannot contribute to the cost of care for a spouse who is institutionalized. 

Keep Up to Date with the Latest Changes with Elder Attorney Services Long Island 

We offer a complete range of long-term care, elder law, estate planning, Medicaid planning and asset protection services. It’s our goal to prevent problems before they occur, and we work with hundreds of families to develop care options that work for their goals and their budgets. For a free 15 minute consultation, contact us by calling (516) 274-9103 or visiting our website here.

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