A child’s disability can change which Medicaid rules count the family’s money. If the child is budgeted under the state’s SSI-related rules as a household of one, the 2026 New York limits are $1,836 a month in income and $33,038 in resources. Some waiver programs go further and look only at the child’s own income and resources, after the parents have applied and been denied.
Which route applies to your child depends on the child’s age, disability finding and the program, and the local social services district makes the call. This page lays out the official numbers and the rules behind them so you can ask the right questions.
Does a child’s disability change Medicaid limits in New York?
It can. State guidance on the OPWDD waivers describes the sequence for a child living with family: Medicaid is first checked under the Modified Adjusted Gross Income (MAGI) category and under ADC-related budgeting, both of which count family income. If the child does not qualify that way, the state says a disability determination would allow the child to be budgeted as a household of one under SSI-related rules, which may be a more favorable outcome.
| Route | Whose money is counted | What to know |
|---|---|---|
| MAGI or ADC-related budgeting | The family’s income | The first test for a child living at home |
| SSI-related budgeting after a disability determination | The child as a household of one | 2026 limits: $1,836 a month and $33,038 in resources |
| Care at Home waivers III, IV and VI (OPWDD) | Only the child’s own income and resources | The parents must apply for Medicaid and be denied first; the child must be under 18 |
What are the 2026 Medicaid income and resource limits for a person with a disability?
New York publishes one table of standards for the non-MAGI population each year. The version effective January 1, 2026, and revised February 5, 2026, lists the SSI-related Medicaid income level and resource level below. The federal SSI limits are far lower, which is why Medicaid and SSI eligibility are not the same thing.
| 2026 standard | Household of one | Household of two |
|---|---|---|
| Medicaid monthly income level (SSI-related) | $1,836 | $2,489 |
| Medicaid resource level (SSI-related) | $33,038 | $44,796 |
| SSI federal benefit rate (monthly) | $994 | $1,491 |
| SSI resource limit | $2,000 | $3,000 |
The Medicaid figures come from the Department of Health’s 2026 chart, and the SSI figures from its January 2026 message to local districts. Both are the state’s own numbers, so they match what your district uses.
Do parents’ income and resources count for a child with a disability?
For SSI, yes, up to a point. Under federal rules, a child living with parents has their income and resources “deemed” through the month the child turns 18. In the month after, and from then on, parental income is no longer deemed. That is why a young adult can qualify for SSI at 18 even though they did not as a child.
For New York Medicaid, it depends on the route in the table above. The waiver route is the clearest. Under the Care at Home III, IV and VI waivers, the state requires:
- The child is under 18 and has a developmental disability as defined by Mental Hygiene Law.
- The child has complex health care needs expected to last at least 12 months and meets the level of care of an intermediate care facility.
- The child is not in a hospital, nursing facility or other institution.
- The parents or legal guardian apply for Medicaid and are denied because of excess income or resources.
- The child is eligible for Medicaid using only the child’s own income or resources.
The child must recertify for Medicaid every year, and the case manager checks yearly that the parents are still ineligible. If the parents have been found eligible for Medicaid within the prior year, the child is no longer eligible for the waiver.
Which assets count, and which do not?
Under the federal SSI rules, which the SSI-related Medicaid category is built on, “resources” means cash or other liquid assets and any property the person owns and could turn into cash for support. Some things are excluded:
- The home: not counted, regardless of value, while it is the principal place of residence.
- One car: one automobile is totally excluded, regardless of value, if it is used for transportation for the person or a member of the household.
- ABLE account savings (for SSI): the first $100,000 does not count toward the SSI resource limit, according to the ABLE National Resource Center.
A second car, extra savings and similar items are counted. Ask your district how it treats an ABLE account for Medicaid before relying on that rule.
What if your child’s income is over the limit?
You have three common options, and a family often uses more than one:
- Pay the difference through spend-down. Our guide to Medicaid spend-down explains the monthly process.
- Use a pooled income trust. In New York, people found disabled can place excess income into a nonprofit’s pooled trust. See pooled income trusts.
- Ask about a waiver. A waiver that looks only at the child’s finances can remove the family’s income from the test entirely.
How is home care for a child approved?
Children do not go through the New York Independent Assessor Program. The Department of Health says all pediatric assessments (ages 0 to 3 and 4 to 17) are excluded from it. Instead:
- Get the physician order. The child’s practitioner completes DOH-4359 or the HCSP-M11Q before the assessment. Our M11q guide and the M11Q form explain the paperwork.
- Request the assessment. The local social services district, or the Medicaid managed care plan, conducts the pediatric Community Health Assessment.
- Review the plan. The district or plan sets the services and hours, and you can ask for a reassessment if the child’s needs change.
If the child needs hourly nursing, see our page on private duty nursing.
What changes when your child turns 18?
The family’s income stops being deemed for SSI in the month after the 18th birthday, so it may be worth applying again if your child was turned down as a minor. Home care assessments change as well. For adults 18 and over, the independent assessor handles initial assessments. The state’s Minimum Needs Requirement applies to people 21 and older seeking personal care or CDPAP, and to anyone 18 and older enrolling in a Managed Long Term Care plan.
Decisions about who can act for your child as an adult also come up around 18. Our page on power of attorney and guardianship covers the options, and CDPAP eligibility explains who can be hired once your child is an adult.
We are a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. We do not decide Medicaid eligibility, but we can help families understand home care options once coverage is in place. Call (718) 232-2777 or use our contact page.
Medicaid limits change every January, and waiver rules differ by program. Everything above was checked on 9 October 2026 against health.ny.gov, law.cornell.edu (20 CFR) and ablenrc.org. The Care at Home guidance we read dates from 2015 and 2017, so confirm current rules with your Local Department of Social Services or a special-needs attorney. This is general information, not legal advice.
Frequently asked questions
What is the Medicaid resource limit for a disabled child in New York in 2026?
For an SSI-related household of one the Department of Health lists $33,038 in resources and $1,836 in monthly income for 2026. Which budgeting route applies to your child depends on the child’s circumstances and the program.
Do parents’ assets count for a child’s Medicaid in New York?
Often yes, under family-based budgeting. Under the Care at Home III, IV and VI waivers, the child is evaluated on their own income and resources after the parents have applied and been denied.
Is the family home counted when a child applies for Medicaid?
Under SSI rules the home is not counted, regardless of its value, while it is the principal place of residence. Confirm how your district applies this to your child’s case.
Can my child have an ABLE account and Medicaid?
For SSI, the first $100,000 in an ABLE account does not count toward the resource limit. Ask your Local Department of Social Services how it treats the account for Medicaid.
What is the Care at Home waiver?
The Care at Home III, IV and VI waivers serve children under 18 with developmental disabilities and complex health needs who live at home. The child’s own income and resources are used, but the parents must first apply and be denied.
Do children get assessed by the New York Independent Assessor Program?
No. The Department of Health excludes pediatric assessments from the program. The local social services district or the Medicaid managed care plan conducts them, using a physician order on DOH-4359 or the HCSP-M11Q.
What happens to my child’s Medicaid at 18?
For SSI, parental income stops being deemed in the month after the 18th birthday. Home care assessments for adults go through the independent assessor, and the state’s Minimum Needs Requirement applies to adults seeking personal care or CDPAP at 21 and to Managed Long Term Care enrollment at 18.
