Medicaid checks your bank account at the time you apply, again during the annual eligibility renewal, and at any point if a discrepancy or red flag comes up. When you apply, the agency runs an electronic Asset Verification System (AVS) search across every financial institution you’ve used in the previous 60 months (the “look-back period”). They can see account balances, not your line-by-line transactions or spending. This guide walks through exactly what they can see, what they can’t, what triggers a check, and what happens if a check reveals something you didn’t report.
Key Takeaways
- Medicaid runs an Asset Verification System (AVS) check at application, at each annual renewal, and any time something looks inconsistent.
- The AVS looks at every financial institution you’ve used in the previous 60 months — including closed accounts during that window.
- Medicaid sees account balances and asset totals, not personal bank statements or transaction-level spending.
- For New York Medicaid eligibility, the income and asset limits are set by the state and updated each year. The current numbers live at NY State of Health and the New York State Department of Health.
- Withholding information — even by accident — can mean losing benefits, owing back the cost of services you received while ineligible, and potential prosecution.
Does Medicaid Check Your Bank Account?
Yes. New York’s Medicaid program reviews bank account balances and asset records during the application process and on an ongoing basis. Because Medicaid is a need-based program with strict financial eligibility, the state has to verify that what an applicant or beneficiary reports actually matches their financial reality.
When the checks happen
Medicaid agencies look at financial information at three points: (1) when you submit your initial application; (2) at each annual eligibility renewal; and (3) any time a discrepancy or a significant change is flagged — for example, an unexpected income source, a property transfer, or an inheritance.
The 60-month look-back period
For applications involving long-term care (nursing home Medicaid, certain home care benefits), Medicaid reviews 60 months of financial history — the “look-back period.” That includes asset transfers, account balances, and major financial moves you made well before applying. If you moved money or assets during the look-back to qualify for benefits, the state can assess a transfer penalty that delays your eligibility.
Your ongoing reporting responsibility
Once you’re approved for Medicaid coverage, you take on some of the responsibility for maintaining your eligibility. If you receive an inheritance, a new income source, or any other change that affects your financial status, you’re expected to report it to your local department of social services — not wait for the next annual check to catch it.
What Information Can Medicaid Access About Your Finances?
New York’s Medicaid program uses the Asset Verification System (AVS) — a federally required electronic tool that pulls account-balance data directly from participating banks and other financial institutions. The AVS is the workhorse behind every Medicaid financial review in NY.
What the AVS can see
- Bank account balances at any financial institution the applicant or their spouse used during the month of application and the prior 60 months
- Balances of accounts that were closed during that 60-month window
- Other assets — retirement accounts, life insurance policies with cash value, brokerage accounts
- Real property the applicant or their spouse owns, through public records searches
- Potential transfers of assets that may need to be verified with paper documentation
What the AVS cannot see
Medicaid agencies can view account balances and asset totals — but not personal bank statements line by line. They can’t see your transaction history, your spending patterns, or specific expenses. The AVS confirms how much you have, not what you spent it on.
The goal of the AVS is not to automate denials — it’s to flag accounts and assets that warrant manual review. The applicant or beneficiary is then responsible for confirming or contesting what the AVS finds with documentation. If you don’t respond, the agency relies on the AVS data as the system of record.
What Are the Medicaid Income and Asset Limits in New York?
New York Medicaid eligibility is determined by income and (for some applicants) by countable assets. The exact limits change each year. New York State of Health, which handles most Medicaid applications, uses Modified Adjusted Gross Income (MAGI) rules for most applicants.
Different rules for different populations
The income and asset limits differ by category:
- MAGI Medicaid (most adults under 65 and children): Income-based eligibility tied to a percentage of the Federal Poverty Level. No countable-asset limit for this group.
- Non-MAGI Medicaid (adults 65+, blind, or disabled, plus long-term care applicants): Both income and asset limits apply. The asset limit is meaningfully higher for this group than it was prior to the 2023 New York reforms.
- Medicaid Buy-In for Working People with Disabilities (MBI-WPD): Higher income and asset limits in exchange for a monthly premium.
Because the specific dollar amounts update at least annually and depend on household size, the current authoritative source is New York State Department of Health and NY State of Health. If you’re trying to figure out whether you qualify, the Marketplace’s eligibility tool will return the current limits for your household and category.
Can you still qualify if your income or assets are above the limit?
Sometimes — yes. New Yorkers who are 65 or older, blind, or disabled and earn or hold more than the standard limit may qualify through the Medicaid spend-down (or “surplus income”) program, which lets you offset excess income with medical expenses. Working people with disabilities can use the Medicaid Buy-In. And for long-term care applicants, planning techniques like pooled trusts can sometimes preserve eligibility — though those require legal guidance.
What Happens If You Withhold Information from Medicaid?
Withholding financial information from Medicaid — whether on purpose or by accident — has real consequences. Medicaid has plenty of ways to verify income and assets through the AVS, public records, and 1099/W-2 tax data, even without your bank statements.
Direct consequences
- Loss of benefits: Coverage can be withdrawn the moment the agency confirms the discrepancy.
- Recoupment: You may be required to pay back the cost of medical services received while you were ineligible. For long-term care recipients, this can be tens of thousands of dollars.
- Future disqualification: Repeated or large-scale misreporting can disqualify you from receiving Medicaid or related public benefits in the future.
- Criminal prosecution: In significant cases, intentional misrepresentation is prosecuted as Medicaid fraud under state law.
Innocent mistakes vs. intentional fraud
Not every missed report is fraud. Some people forget to update their Medicaid case when they get an inheritance. Others don’t realize a side income source counts. Some are worried about losing the money they worked for. Whatever the reason, the consequences are similar — but a one-off small discrepancy is treated very differently from sustained or large-scale misreporting.
The safer path
If you’re unsure whether something needs to be reported, ask your local department of social services before the AVS finds it. Reporting a change proactively is almost always less costly than letting Medicaid discover it on the next annual check. If a planning question is more complex — an asset transfer, a property sale, an inheritance — consult a Medicaid planning attorney before moving the money.
Need Help Navigating NY Medicaid Coverage for Home Care?
At Friends & Family Home Care, we work with New York Medicaid members every day for HHA and PCA home care services. We don’t determine eligibility — that’s the local department of social services and NY State of Health — but we can help you understand what your coverage allows and how to set up Medicaid-covered home care once you’re approved. Contact us to talk through what’s possible.
