Your Medicaid surplus is the part of your monthly income that is above what Medicaid lets you keep. It is also called a spend-down or excess income. Only Medicaid decides the amount, and it sends you a letter with one amount and the month it starts. In a pooled income trust, that amount goes into your trust account each month instead of being paid to Medicaid.
We work out your number on the first call. A person picks up.
The 2026 Medicaid income limits in New York
For 2026, you can have up to $1,856 a month for one person and $2,509 a month for a couple and still qualify (the state's 2026 levels of $1,836 and $2,489, plus the $20 that Medicaid disregards). Anything above that is your surplus. The figures change every January, and your caseworker sets your exact number from your own income papers, after any deductions you are allowed. Checked October 2026 against the state's 2026 levels; the state explains the program on its excess income page.
Married? Medicaid normally counts both incomes. If only one of you needs Medicaid and you want only that income counted, the other spouse signs a spousal refusal. We explain how that works on the call.
Estimate your surplus
Type the net monthly amount shown on each award letter, the way we do on the phone. Leave a line blank if it does not apply.
Who decides the amount?
Only Medicaid does. Medicaid looks at your income and sends you a letter, called a budget letter or a notice of decision. It states one amount and the month it starts. Not the trust, not your family and not a Medicaid consultant sets the amount. We follow the letter.
Why the number can change
- Your Social Security or pension goes up, often in January.
- Medicaid reviews your case each year (your recertification) and rebudgets your income.
- Medicaid sometimes decides the new amount applies from an earlier month than you expected.
Please send us every Medicaid letter the day it arrives. If the amount goes up from an earlier month, there can be a catch-up amount to pay, and the sooner we know, the smaller the surprise. We follow the letter, and we talk to you before taking any catch-up amount.
Why the monthly deposit matters
Medicaid covers a month only if the right amount went into the trust for that month. That is why the deposit is set up to come out of your bank account on the same day each month.
What if you miss a month?
Tell us as soon as you know. A missed or returned deposit can put your coverage for that month at risk, and a returned payment can carry a bank return fee. We do not take our own fees until a returned deposit is made good. We would rather hear about a problem early and work out a plan.
Common questions
What is a Medicaid surplus?
The part of your monthly income that is above what Medicaid lets you keep. It is also called a spend-down or excess income.
Who sets my surplus amount?
Only Medicaid. It sends a budget letter or notice of decision with one amount and the month it takes effect.
Why did my surplus go up?
Common reasons are a Social Security or pension increase, the yearly Medicaid review, or Medicaid applying a new amount from an earlier month. Send us the Medicaid letter and we will update your deposit to match it.
Do I have to use a pooled income trust for my surplus?
No. You can pay the surplus to Medicaid each month instead. A pooled income trust lets you keep that money for your own bills.
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