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Applying For and Keeping Medicaid
Medicaid Renewals/Recertifications in NYC- Resume March 2023 - Now can file online!
This article available as a fact sheet in ENGLISH and SPANISH This article is for people whose Medicaid is administered by the NYC Medicaid program, run by the Human Resources Administration (HRA). If your Medicaid is handled by the New York State of Health – your renewal is not covered in...
Medicaid & MSP: Must apply for Social Security and Enroll in Medicare
Medicaid applicants and recipients can be required to pursue potentially available income, including Social Security, as a condition of receiving Medicaid, and also to apply for Medicare. (42 CFR 435.608; 18 NYCRR sec. 360-2.3 (c)(1); Medical Assistance Resource Guide [MARG] pp. 488-489.) ...
Applying for Medicaid Personal Care or CDPAP Services in New York City - 2021-2022 Changes
May 16, 2022 Update - The new NY Independent Assessor (NYIA) starts being phased in. See info about that huge change in this article. Starting May 16, 2022 the M11q is no longer required for people applying to HRA for Medicaid home care who are NOT seeking MLTC because they are exempt or excluded...
Know Your Rights: NYLAG Webinars on Medicare and Medicaid -
The Evelyn Frank Legal Resources Program conducted a five-part Continuing Legal Education Webinar program in April and May 2016 that provides tools to understand and navigate the complex world of Medicare and Medicaid in New York. The focus is on eligibility and application procedures for older...
Getting Help with Managed Long Term Care
Here are organizations where you can seek help for problems with Medicaid Managed Long Term Care and Medicaid Advantage Plus. Also see these KNOW YOUR RIGHTS Fact Sheets about MLTC and related topics STATEWIDE ICAN – Independent Consumer Assistance Network – ...
"MAGI" Medicaid Eligibility under the Affordable Care Act - Rules for Most People Under age 65 Without Medicare
Medicaid eligibility rules changed significantly on January 1, 2014 for some New Yorkers as a result of the Affordable Care Act’s eligibility expansion and streamlining provisions. The expansion only applies to a population called the "MAGI" population. Generally, the new rules do NOT apply to...
NYS Directives on Medicaid changes under the Affordable Care Act
The New York State Department of Health (DOH) has issued additional directives outlining the new procedures for Medicaid applications and renewals under the Affordable Care Act, effective in 2014. For NYC directives click here. NYS DIRECTIVES (beginning with oldest - scroll down for newer ones)...
Keeping Medicaid after Cash Public Assistance or SSI Benefits Are Terminated
Scenarios: Susie is 49 years old and single, with no children. She has been receiving cash public assistance and Medicaid for three years, while she appeals the denial of Social Security Disability Insurance Benefits ("SSD" or "DIB"). She finally was approved for SSD, and will start receiving...
Where to Apply for Medicaid and Medicaid Home Care in New York City
COVID-19 ALERT - Many Medicaid offices are closed during the emergency. There is one Medicaid office open in each borough where you can file an application - see this list. Or you can now FAX an application to 917-639-0732. During the COVID emergency, you do not need to submit as many...
Applying for Medicaid Personal Care Services and CDPAP Outside NYC - 2016 Changes
New York State's Medicaid program covers personal care services and consumer-directed personal assistance services. The model for delivery of those services has, in the years since 2011, gradually transitioned from the local departments of social services, through their Medicaid programs, to...
"Immediate Need" Fast-Track Application for Medicaid and Personal Care or CDPAP - Independent Assessor Starts Dec. 1, 2022
Medicaid has a fast-track procedure to apply for Medicaid in order to obtain home care services, which has been faster than enrolling in a managed long term care plan. Click here to learn about the reasons for MLTC enrollment delays. The 2015 New York law requires approval of Medicaid in only...
KNOW YOUR RIGHTS: Fact Sheet Explaining Basic Rules on NYS Financial Medicaid Eligibility for People who are Disabled, Aged 65+, or Blind
This Fact Sheet (updated 02/20/2024 with 2024 figures) explains Medicaid eligibility for New Yorkers who are age 65+ or who have disabilities. It explains the basic financial rules on eligibility for Medicaid in the community for this category of people, and explains how to apply for Medicaid if...
Elimination of Face to Face Interview for Medicaid and Family Health Plus applicants
As of April 1, 2010, applicants for Medicaid and Family Health Plus (FHP) are no longer required to have a face to face interview as part of the application process.  Applications can now be mailed or dropped off at local Medicaid offices.  Unfortunately, the federal government...
Financial maintenance requirements at application and renewal
 In September, 2011, NYS Department of Health (DOH) clarified the administrative directive 10ADM-06 Standardized Financial Maintenance Requirements for Medicaid Applicants/Recipients,  which in June, 2010,  established a standardized methodology by which local social...
NYS Medicaid Application Form (updated 2021) for Age 65+ or Disabled or Blind - New Supp A NYC 2021
Since 2010, the New York State Department of Health Medicaid application form is called the Access NY Application or Health Insurance Application or form DOH-4220. Download the most recent version of the form at this link. (As of 02-06-24, the form was last updated in January 2023.) For those...
When Documentation of Resources and Income is Required for Medicaid Applications & Renewals - and When is "Attestation" Enough?
Since 2004, Medicaid documentation requirements have been simplified by allowing some applicants merely to "attest" rather than document certain eligibility factors. In that year, attestation to the amount of one's resources was first allowed for Medicaid applicants who were not seeking Medicaid...
Medicaid Disability Determinations - NYS Forms & Procedures (with updated forms Dec. 2021)
The Medicaid program has long had a procedure for determining disability for individuals who have not yet been determined disabled by the Social Security Administration.[1] This procedure is needed in order to approve pooled trusts for people age 65+ and also for other reasons described here. The...
Medicaid Alerts & Other Protocols published by the NYC HRA Medicaid Program
HRA Medicaid Alerts are periodic announcements of policy, staff and office changes published by the HRA Medicaid Progarm (formerly called the "Medical Insurance and Community Services Administration (MICSA)". The Medicaid Program is the part of New York City’s Human Resource Administration...
Delays in Processing of Medicaid Applications - What are Your Rights and Lawsuits Challenging Delays
The Deadlines to Process Medicaid Applications in the Law Federal and state law set time limits for processing a Medicaid application. The federal Medicaid Act requires eligibility to be determined with "reasonable promptness." A determination of eligibility for Medicaid must generally be made...
New York Medicaid Expansion
Know Your Rights: What You Need to Know About NYS Medicaid Expansion in 2023 This year’s Health Budget makes significant changes to New York’s Medicaid program – expanding eligibility to 133% of the federal poverty law (FPL) and changing budgeting rules and enrollment processes for...

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