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Medicaid Long Island

Medicaid Long Island Qualifications: Residency

In order for applicants to qualify for Medicaid on Long Island, they must meet various requirements for Medicaid eligibility under New York law. One of these key requirements is residency. The applicant must be a legal resident of New York State. This does not, however, mean that the applicant must have been living in New York for any particular time period. An individual who has been living in New York for only one day can be eligible for Medicaid if all other Medicaid qualifications are met.

Residency can be established in one of two ways. One way is for the applicant to declare his or her intent to establish a permanent home in New York. Some factors that are considered in determining one’s intent are the applicant’s mailing address, voting address, address on his or her driver’s license, etc. The Department of Social Services (the agency that administers the Medicaid program) looks at these objective factors to ensure that the individual is actually a resident of the State.

The second way to establish residency is based upon the “where found” rule. The “where found” rule applies when the applicant is unable to state his or her intent to reside in New York but residency is nevertheless determined by the physical location of the applicant. For example, an individual from Florida who suffers a severe stroke while visiting Long Island and who now requires Medicaid services on Long Island may be eligible for those services assuming the individual meets all other financial requirements. Since the individual lacks the capacity to establish residency, Medicaid looks to his or her physical presence, which is Long Island.

After an individual is deemed a New York State resident, he or she can receive medical services (i.e. home care or skilled nursing care) anywhere in the State. Residency in a particular county does not affect where an individual can receive medical care, but it does affect which county is responsible to pay for Medicaid’s portion of the medical bill. The county in which the applicant resides is the county that is ultimately financially responsible, no matter where the care is being provided.

It is also important to note that even if an applicant receiving Medicaid on Long Island in one county moves to another county within New York, the individual is not required to reapply for Medicaid in the new county. This wasn’t always the case. However, the same cannot be said for moving out of state because every state has its own Medicaid eligibility rules. For example, being qualified for Medicaid on Long Island does not necessarily mean an individual can qualify for Medicaid in Florida.

Long Islanders who are receiving New York Medicaid and are thinking about moving out of state should consider the consequences of having to reapply in the new state. New York Elder Law attorneys should advise these clients on the various Medicaid planning strategy issues associated with such a move. First, moving out of state will create a gap in Medicaid coverage because they may have to establish their residency in the new state before applying and ultimately being approved. Second, moving out of state might mean that the new state’s Medicaid program will no longer pay for the type of medical care the individual requires. Many states either do not provide home care assistance under Medicaid or they do not provide such care to the same degree as that in New York.

Lastly, moving out of state may be problematic for individuals whose Medicaid planning strategies were based upon “spousal refusal” because only three states recognize the spirit of the law: New York, Connecticut and Florida. Therefore, moving to a state that does not recognize spousal refusal may mean that both spouses’ income and assets may be counted by Medicaid in determining the ill spouse’s eligibility. Thus, New York Elder Law attorneys on Long Island should advise clients who are considering an out of state move to seek the advice of an Elder Law attorney in the state in which they are considering to reside.

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