Updated August 27, 2026. Quick answer: New York gives the programme a name of its own: “Here we will be referring to it as the Excess Income program.” “The amount your income is over the Medicaid level is called excess income.” The provision most people miss is that a single payment can cover a stretch: in the state’s example, “the paid amount of $360 can be used to meet your excess income for six months”.
What New York requires
| What the state sets out | What it says |
|---|---|
| New York’s name for it | Excess Income program |
| What excess income is | “The amount your income is over the Medicaid level is called excess income.” |
| How you meet it | “you can show that you have medical bills equal to your excess income in a particular month” |
| Who is eligible | “You must be under age 21, age 65 or older, certified blind or certified disabled, pregnant or a parent of a child under age 21.” |
| The state’s six-month example | “the paid amount of $360 can be used to meet your excess income for six months” |
How it works in practice
- The six-month effect is the fact worth acting on. New York’s own example shows a paid amount being applied forward: “the paid amount of $360 can be used to meet your excess income for six months”. That turns a lumpy medical bill into months of coverage.
- Bills, not cash, are the normal route: “you can show that you have medical bills equal to your excess income in a particular month”, and Medicaid pays the rest of that month.
- The programme is not open to everyone over income. “You must be under age 21, age 65 or older, certified blind or certified disabled, pregnant or a parent of a child under age 21.” An over-income adult who fits none of those categories is outside it.
The mechanism itself — why an income cap exists and what the trust must contain — is explained on the income-cap and Miller trust page. This page is the New York record.
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How our partner relationships workWhat this page does not settle
- The excess income amount itself is set by the caseworker on your file, against the Medicaid level for your household. This page does not publish a current level, because the state publishes those separately and they change.
- This page reads one source: New York State Department of Health, Medicaid Excess Income program. It is the state’s own publication on this rule, but no state puts its whole treatment of excess income in a single document, and a detail that decides your case may sit in one this page did not read.
- A spend-down fixes an income problem and nothing else. The resource test, the level-of-care test and the transfer-of-assets look-back are separate hurdles, each decided on your own file, and meeting this rule does not clear any of them.
- Every quotation here was read against the source on August 27, 2026. States revise these rules, and a figure or a section number can move without the page around it changing. Open the source before you rely on a detail.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or assign income on the strength of a web page.
Figures verified against the New York State Department of Health Medicaid Excess Income program page on September 29, 2026.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
Before the excess-income rule applies, there is the eligibility test itself: New York’s Medicaid nursing-home income test sets out the figure or the mechanism the state actually uses, with its primary-source citation.
Related: New York’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.
Related: New York’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
For your own numbers, run the Medicaid Spend-Down Calculator: Income Trust or Spend-Down, by State.
See Medicaid Estate Recovery by State: What Each State Can Reach (2026) for the full state by state breakdown.