Short answer
New York expanded Medicaid under the ACA effective January 1, 2014, covering adults 19-64 up to 138% of the federal poverty level with no asset test. That expansion population is a different eligibility pathway from the non-MAGI aged/blind/disabled pathway seniors use to qualify for long-term-care Medicaid, which is asset-tested.
Two different tests, two different populations
ACA expansion Medicaid is income-based only, for adults under 65. Long-Term Care Medicaid for seniors uses New York's non-MAGI aged/blind/disabled pathway, which tests both income and countable assets, and applies its own rules for spousal protections and estate recovery. A senior does not become eligible for nursing-facility or MLTC-covered care through the ACA expansion pathway.
2026 figures worth knowing
- NYC-region MLTC special income standard for housing expenses: $1,790/month (effective January 1, 2026; distinct from Long Island's $1,701).
- Nursing home resident Personal Needs Allowance: $50/month -- unchanged since the 1980s, among the lowest in the country. A 2024 state senate bill proposed raising it to $128; it remains $50/month as of this writing.
- Standard Medicare Part B premium (2026): $202.90/month for income at or below $109,000/year.
Source: NYSDOH GIS 26 MA/03
