​Non-MAGI Medicaid and Medicare Savings Program Expansions Starting in January 2023

Published on December, 31 2022 by Michelle Berney

Effective January 1, 2023, there are increases to non-MAGI Medicaid income and resource limits, as well as increases to the Medicare Savings Program (MSP) income limits. As a result of these changes, more people will qualify for these benefits. In addition, those who already have non-MAGI Medicaid and/or a MSP need to understand what these expansions mean for them.

Non-MAGI Medicaid Increases

Non-MAGI Medicaid monthly income limits will increase from (Note: The higher figures for 2023 represent 138% of the 2022 federal poverty levels and will be adjusted when the 2023 federal poverty levels are posted in the Federal Register.):

  • $934 to $1,563 for a household size of 1,
  • $1,367 to $2,106 for a household size of 2.

Resource limits will increase from:

  • $16,800 to $28,133 for a household size of 1,
  • $24,600 to $37,902 for a household size of 2.

Medicare Savings Program (MSP) Increases

MSP income limits will increase as follows (figures reflect 2022 FPL as 2023 FPLs have not yet been posted):

  • QMB income limits will increase from 100% FPL to 138% FPL ($1,153 to $1,563 single/$1,546 to $2,106 married).
  • QI income limits will increase from 135% FPL to 186% FPL ($1,549 to $2,107 single/$2,080 to $2,838 married).

Notices of Changes

Some individuals who have non-MAGI Medicaid and/or a MSP should have received notices from the NYS Department of Health in December 2022:

  • Individuals with a Medicaid spenddown should have received a letter informing them that, due to the increase in Medicaid income limits, their spenddown amount may be reduced as early as January 2023.The letter specifies that they do not need to do anything now, but they can reach out to the LDSS (HRA in NYC) on or after January 1, 2023, and request for their case to be rebudgeted so they can start to pay a lower spenddown prior to their next recertification date. In addition, they can ask to be enrolled in QMB, if not already enrolled.
  • Individuals with a Medicare Savings Program (and not Medicaid) should have received a notice informing them that they can submit either a Medicaid application + Supplement A to upgrade their coverage to Medicaid, as long as their assets are within the 2023 resource limits, or the MSP application (DOH-4328) if they want QMB and not Medicaid.

In addition, NYC residents who have Medicaid with a spenddown will ALSO receive a letter from HRA in January 2023 with a bar-coded form to self-attest to their 2023 income and deductions (including pooled trusts). It is the individual’s choice as to whether to complete and return the form. Individuals who choose to return the form (in the pre-addressed, postage-paid, envelope) will have their Medicaid case rebudgeted back to January 1, 2023; those who do not return the form will have their cases rebudgeted at the time of their next recertification.

Social service providers may want to ask their clients who have Medicaid with a spenddown and/or a MSP whether they received notices from DOH.If they haven’t received notices, please share the information above; also, confirm whether they may need to update their address with Medicaid.

NYC residents who have Medicaid with a spenddown who do not receive the mailing from HRA should update their address with their local Medicaid office and update their financial information (if they wish).