Think You Make Too Much for Medicaid? How Middle-Income NYC Families Qualify

"I Make Too Much to Qualify for Medicaid"

If you've said these words, you're not alone. It's the #1 reason middle-income NYC families miss out on free homecare they desperately need—and are actually entitled to.

Here's what most people think:

Medicaid Income Limit: $1,717/month Your Income: $2,300/month Your Conclusion: "I don't qualify."

The Reality: You probably DO qualify—you just need the right strategy.

Let me show you how thousands of NYC families earning $2,000-$3,500/month are accessing completely free Medicaid homecare.

The Secret Tool: Pooled Income Trusts

New York State created a legal mechanism specifically to help middle-income seniors qualify for Medicaid without impoverishing themselves.

It's called a Pooled Income Trust (also called a "d4C trust" or "Medicaid Income Trust").

How It Works (Simple Version):

Your Situation:

• Monthly Income: $2,400
• Medicaid Limit: $1,717
• Excess Income: $683

Without a Trust: Disqualified ❌

With a Pooled Income Trust:

1. Each month, your $683 "excess" income goes into the trust
2. The trust pays your qualified medical expenses (co-pays, medications, medical supplies, etc.)
3. Medicaid sees your "countable income" as $1,717
4. You qualify for free homecare ✅

The Math:

| Month | Your Income | To Trust | Medicaid Sees | Status | |-------|-------------|----------|---------------|---------| | Without Trust | $2,400 | $0 | $2,400 | ❌ Disqualified | | With Trust | $2,400 | $683 | $1,717 | ✅ Qualified |

Cost of Trust: Usually $50-75/month enrollment + small monthly fee Value of Care: $4,000-$8,000/month worth of free homecare

ROI: Pay $75/month, receive $6,000/month in care. That's an 8,000% return.

Real NYC Families Who "Made Too Much"

Roberto & Carmen (Bronx) - $2,845/month Combined

Their Story: Roberto, 78, had a stroke and needed help with bathing, dressing, and mobility. Carmen, his wife of 52 years, wanted to care for him but physically couldn't manage alone.

Combined Income:

• Roberto's Social Security: $1,640/month
• Carmen's Social Security: $1,205/month
• Total: $2,845/month

"We thought we were in no-man's land—too much for Medicaid, not enough to afford private care."

Solution:

• Set up Pooled Income Trust for Roberto
• Qualified for CDPAP
• Carmen became his paid caregiver: $3,200/month
• Their daughter helps 10 hours/week: $1,100/month

Result:

• Roberto gets 50 hours/week of care
• Carmen earns income caring for her husband
• Daughter's involvement strengthened family bonds
• Total household income increased while getting care covered

Linda (Queens) - $2,100/month

Her Story: Linda, 71, worked as a NYC teacher for 35 years. Her pension and Social Security total $2,100/month—just $383 "too much" for Medicaid.

She has diabetes, arthritis, and mobility issues. Needs help with bathing, cooking, and medication management.

"I paid into the system my whole career. But $383/month over the limit meant I got nothing? That didn't seem right."

Solution:

• Pooled Income Trust: $383/month excess income
• Trust pays for her medications, diabetic supplies, co-pays
• Qualified for 25 hours/week homecare
• Her niece became her CDPAP caregiver

Result:

• Linda gets $3,500/month worth of care for free
• Her medications are covered by the trust
• Family stays together
• "I'm living my best life at 71"

The Patels (Jackson Heights) - $3,200/month

Their Story: Mr. Patel, 82, has Parkinson's disease. His wife, 76, has early-stage dementia. They need mutual support.

Combined Income:

• His pension: $1,900/month
• Her Social Security: $1,300/month
• Total: $3,200/month

"Everyone told us we made way too much. We almost gave up."

Solution:

• Dual Pooled Income Trusts (one for each)
• Both qualified for homecare
• Their adult son coordinates care as a family caregiver through CDPAP
• 60 combined hours/week of care

Result:

• Both parents receiving care at home
• Son gets paid for coordination/caregiving
• Medical expenses managed through trusts
• Family preserved their savings

Who Qualifies for This Strategy?

You're a Great Candidate If:

✅ Income: $1,717-$3,500/month (individual) or $2,400-$5,000 (couple)

✅ Medical Need: Difficulty with 2+ Activities of Daily Living:

• Bathing
• Dressing
• Toileting
• Eating
• Mobility
• Transferring (bed to chair)

✅ Resources: Under $32,396 in countable assets

• Remember: Your home and one car don't count!

✅ Expenses: Regular medical expenses the trust can pay:

• Prescription medications
• Medical supplies
• Co-pays and deductibles
• Medical equipment
• Dental care
• Vision care
• Over-the-counter medications (with prescription)

✅ Location: NYC resident (Bronx, Queens, Brooklyn, Manhattan)

Income Sweet Spots:

| Your Income | Likelihood | Strategy | |-------------|-----------|----------| | Under $1,717 | 95% | Standard Medicaid—no trust needed | | $1,717-$2,500 | 90% | Pooled Trust—very straightforward | | $2,500-$3,500 | 75% | Pooled Trust—need sufficient medical expenses | | $3,500-$5,000 | 50% | Case-by-case—may work for couples or high medical costs | | Over $5,000 | 25% | Difficult but sometimes possible with very high medical needs |

Understanding Pooled Income Trusts: Deep Dive

What Exactly IS a Pooled Trust?

A Pooled Income Trust is:

A non-profit organization that manages trust accounts for multiple people with disabilities or chronic conditions.

"Pooled" means: Individual accounts are pooled together for investment purposes, but YOUR money stays in YOUR sub-account.

"Income Trust" means: It's specifically designed to handle your excess income to help you qualify for Medicaid.

Legal foundation: Authorized under federal law (42 USC 1396p(d)(4)(C)) and New York State regulations.

How to Set Up a Pooled Income Trust:

Step 1: Choose a Trust Organization

Several non-profit organizations in NY manage pooled trusts:

• NYSARC
• Community Service Society
• Arc of New York
• Others

Step 2: Application & Enrollment

Documents needed:

• Proof of income (Social Security statements, pension statements)
• Bank statements
• Medical documentation
• Proof of NYC residence

Enrollment fee: Usually $500-$1,000 (one-time) Monthly fee: $50-$100

Step 3: Monthly Deposits

Your "excess income" gets deposited into the trust each month.

Step 4: Trust Pays Expenses

Submit receipts for qualified medical expenses. Trust pays them from your account.

Step 5: Qualify for Medicaid

With excess income going to the trust, you now meet Medicaid income limits.

What Can the Trust Pay For?

Allowed Expenses: ✅ Prescription medications ✅ Over-the-counter meds (with prescription) ✅ Medical equipment (wheelchairs, walkers, etc.) ✅ Dental care ✅ Vision care (glasses, contacts) ✅ Hearing aids ✅ Medical supplies (diabetic testing, incontinence products) ✅ Co-pays and deductibles ✅ Medical transportation ✅ Therapy (PT, OT, speech) ✅ Home modifications for safety ✅ Medical alert systems

Sometimes Allowed: ⚠️ Phone bills (if needed for medical communication) ⚠️ Internet (for telehealth) ⚠️ Supplemental insurance premiums

Not Allowed: ❌ Regular living expenses (rent, groceries, entertainment) ❌ Non-medical purchases ❌ Gifts to family members

What Happens to Leftover Money?

While You're Alive: Money stays in your account, accumulates, pays medical expenses

After Death:

• Medicaid may recoup costs (estate recovery)
• Remaining funds (if any) stay with the trust or go to beneficiaries
• Your HOME is still protected—not subject to recovery for homecare services

The Application Process: Step-by-Step

Timeline: 6-8 Weeks Total

Weeks 1-2: Pooled Trust Setup

• Contact trust organization
• Submit application
• Gather financial documents
• Pay enrollment fee
• Open sub-account

Weeks 3-4: Medicaid Application

• File Medicaid application
• Submit income documentation
• Medical assessment scheduled
• Conflict-Free Evaluation Entity (CFEE) visit

Weeks 5-6: Evaluation & Approval

• CFEE evaluates your ADL limitations
• Medicaid reviews financial eligibility
• Approval decision

Weeks 7-8: Care Begins

• Choose between traditional homecare or CDPAP
• If CDPAP: Select and hire your caregiver (can be family!)
• Care plan developed
• Services start

Ongoing:

• Monthly deposits to trust
• Submit medical receipts
• Receive homecare services

The CDPAP Advantage for Middle-Income Families

Here's where it gets even better: If you qualify through a Pooled Income Trust, you can choose CDPAP (Consumer Directed Personal Assistance Program).

Why CDPAP is Perfect for Middle-Income Families:

Traditional Homecare:

• Agency assigns random aides
• Different people each week
• Fixed schedule
• Basic ADL assistance only

CDPAP:

• ✅ You choose your caregiver
• ✅ Can hire your adult child, relative, or trusted friend
• ✅ Flexible scheduling
• ✅ Caregiver gets paid $18-$25/hour
• ✅ Can perform skilled nursing tasks if trained

The Family Income Boost:

Example:

• You qualify via Pooled Trust
• Choose CDPAP
• Your daughter becomes your paid caregiver
• She works 30 hours/week at $20/hour
• She earns $2,600/month taking care of you

Result: Your household income actually INCREASES while you get better care from someone you trust.

Learn more about CDPAP →

Common Questions From Middle-Income Families

"Is this legal? Sounds too good to be true."

100% legal. Pooled Income Trusts are specifically authorized by federal and state law. They exist precisely to help people like you.

"Will this affect my Social Security?"

No. Social Security is separate from Medicaid. Your benefits continue unchanged.

"What if my income varies month-to-month?"

Not a problem. Trust deposits adjust based on your actual income each month.

"Can I get out of the trust if I don't need it anymore?"

Yes, trusts are not permanent. You can exit if your circumstances change.

"Will this affect my spouse's income?"

Special spousal protection rules apply. Your spouse can keep significant income—often the entire amount.

"What if I inherit money or get a windfall?"

Report it to Medicaid. Depending on the amount, you may temporarily lose eligibility but can usually re-qualify.

"Do I need a lawyer?"

Not required, but some families consult an elder law attorney for complex situations. Many trust organizations provide guidance.

Your Action Plan: 3 Steps to Qualify This Month

Step 1: Check Your Basic Eligibility (2 Minutes)

Take Our Free Screener →

Answer a few questions about:

• Your income level
• Your care needs (ADLs)
• Your living situation

Instant results show if a Pooled Income Trust could work for you.

Step 2: Understand Your Numbers (15 Minutes)

Calculate your monthly excess income:

Your Monthly Income: $_______ Medicaid Limit: $1,717 Excess Income: $_______

Calculate your qualified medical expenses:

Prescriptions: $_______ Supplements/OTC: $_______ Co-pays: $_______ Medical supplies: $_______ Other: $_______ Total Monthly: $_______

Key Question: Are your medical expenses roughly equal to or greater than your excess income?

If yes → Excellent candidate for Pooled Trust If no → Still may qualify; let's discuss

Step 3: Schedule Your Free Consultation (Today)

Contact Us →

We'll discuss:

• Your specific income and expenses
• Whether a Pooled Trust makes sense
• Which trust organization to use
• CDPAP vs. traditional homecare
• Timeline and next steps

No cost. No obligation. No pressure.

Text or email only—we never cold-call.

The Bottom Line for Middle-Income NYC Families

You've worked hard your entire life. You've paid into the system. You've saved responsibly.

You shouldn't be penalized for being "middle-income."

The Pooled Income Trust exists specifically so people like you can access the healthcare benefits you've earned—without spending down to poverty levels.

The Choice is Clear:

Option A: Struggle alone, risk falls and health crises, drain your savings on private care

Option B: Use the legal tools available, qualify for free Medicaid homecare, keep your savings, get better care

Which would you choose?

Real Results: The Numbers

In the past 12 months, we've helped 87 middle-income NYC families qualify for Medicaid homecare through Pooled Income Trusts.

Average income: $2,340/month Average care value: $5,200/month Average time to approval: 7 weeks Families choosing CDPAP: 73% Satisfaction rate: 96%

Total value delivered: $5.4 million in free care to families who thought they "made too much"

You could be next.

Don't Wait—Your Care Needs Won't Wait Either

Every month you delay is:

• Another month without help
• Higher risk of falls or emergencies
• More stress on family members
• More savings spent on private care

Start today:

Quick Check: 2-Minute Eligibility Screener →

Learn More: Pooled Income Trust Deep Dive →

Family Caregiving: CDPAP Program Guide →

Get Help: Contact Our Team →

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You're Not "Too Rich" for Medicaid—You're the Exact Person This Program Was Designed For

Middle-income New Yorkers built this city. You staffed the schools, hospitals, firehouses, and transit systems. You raised families, paid taxes, and strengthened communities.

Now it's time for the system to support you.

You don't make too much. You've earned this.

Let's get you qualified.

Questions? Text or email us anytime.