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NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2023
2001_to_2023_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2023. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
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11 Mar, 2024
3.52 mb
Downloads: 299640
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Medicaid income and resource levels - 2023 (06-06-23)
HRA chart March 1 2024.pdf
NYC HRA MAPDR-01 (updated4-5-2023) -- 2023 NYS Income and Resource Standards revised. Note these now use 2023 Federal Poverty Levels so should be the FINAL figures for 2023.
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01 Mar, 2024
304 kb
Downloads: 440576
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2023-12-28 Contact Information Update for the Medical Assistance Program's Third-Party Health Insurance Unit
2023-12-28 Contact Information Update for the Medical Assistance.pdf
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06 Feb, 2024
136 kb
Downloads: 88
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Supplemental Needs Trusts Outline for Advocates - Including Impact on Various Benefits of Transfers of Lump Sums into SNT's UPdated 6/2023
SNT Outline 2023-06.pdf
Training Outline for Advocates on Supplemental Needs Trusts (SNTs) (individual and pooled), and the effect of SNTs on various public benefit programs (updated 6/30/2023). Updated sections include Temporary/Public cash assistance, SNAP, ABLE accounts, Public Housing and Section 8, changes in procedures for submitting pooled trusts in NYC. Also heads up about 2023 increases in Medicaid income and asset limits and update about the 30-month community based lookback).
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01 Jul, 2023
1.3 mb
Downloads: 214888
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MAPDR-05 (08/04/2022) List of Managed Care & Managed Long Term Care Plans in NYC
2022-08-04 MAPDR-05 Medicaid Managed Care Plans NYC.pdf
This includes a list of all managed care organizations participating in the following types of Medicaid managed care, including ID and code numbers, contact information, and service areas:
* Medicaid Managed Care
* Health and Recovery Plan Managed Care Plans (HARP)
* Managed Long Term Care (MLTC)
* Medicaid Advantage Plus (for dual eligibles, includes MLTC)
* HIV Special Needs Plans (SNP)
* Programs of All-inclusive Care for the Elderly (PACE)
* Fully Integrated Dual Advantage (FIDA) IDD
Updated August 4, 2022 (current on HRA site as of 5/31/23)
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31 May, 2023
129 kb
Downloads: 60782
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MAP-909E DAB Renewal Form Redacted (2022-01-04)
MAP-909e DAB Renewal (2022-01-04) Redacted Sample with 2023 ACT NOW insert.pdf
HRA Medicaid Renewal Form being sent in 2023 to Disabled, Aged, & Blind (DAB) recipients in the "unwinding" of the Public Health Emergency. Note that the packet contains
(1) a 2-page Renewal Notification letter with the deadline to return the renewal, which is always the 10th of the 2nd month after the notification,
(2) "ACT NOW" alert intended to alert consumers that this renewal MUST be returned, unlike those sent during the Public Health Emergency (MAP-3185 - 2023-01-19),
(3) Renewal form has a new section in Part 6 RESOURCES requiring authorization for HRA to verify resources using data matching (page 6 of the PDF);
(4) Renewal form must be signed by both applicant and spouse (p. 9 of PDF)
(5) Financial Maintenance form - not new - only required if housing costs are more than 70% gross monthly income (p. 10 of PDF);
(6) NEW: Authorization for Verification of Resources - Recipient and Spouse each must sign this and send back with renewal!
(MAP-3179 and 3179a) (pp. 11-13 of PDF)
(7) Renewal instructions (pp. 14-16 of PDF)
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31 May, 2023
2.17 mb
Downloads: 10656
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Using an SNT to Eliminate the Medicaid spend-down - Fact Sheet (May 2023)
SNT Short 2023-05 FINAL.pdf
How to get Medicaid despite having "excess income" - Using a Supplemental Needs Trust to Eliminate the Spend-down for Persons who are Elderly (65+), Blind or Disabled. Written by New York Legal Assistance Group Evelyn Frank Legal Resources Program, updated May 2023 with new procedures in NYC for submitting disability forms, and with 2023 figures.
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23 May, 2023
476 kb
Downloads: 159432
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HRA MAP 259d Nursing Home Discharge Alert - for Community Budgeting & Related Forms with various forms updated as of 3-24-2023
MAP-259d-e-f-g-t Discharge Alert and Related Nursing Home Forms as of 2023-03-24 (259f -259t+ 648p).pdf
NYC MICSA Medicaid Alerts from 2015 and 2020 with nursing home forms updated as of 3/23/23 including "Discharge Alert" 259d that nursing home physician must sign to certify that resident has a reasonable expectation to return home, which entitles resident to community budgeting (non-chronic care) - so they keep entire community Medicaid allowance rather than only $50/month. Form replaces 1159. PDF includes - Form 259f Notice of Discharge revised 2020 (now includes check-off that resident advised of Special Income Standard for those discharged from NH to MLTC) ; Form 259e (Change/Cancellation of Discharge Plan), 259g (Respite Alert), 259t (updated 5/2020) -- PDF has updated forms as of 3/24/2023 from NYC MARC website.
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25 Mar, 2023
3.04 mb
Downloads: 73906
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MAP-648 P SUBMISSION OF REQUEST FROM RESIDENTIAL HEALTH CARE FACILITIES (RHCF)(05/05/2022)
MAP-648p Submission of request from RHCF-NH 2022-05-05.pdf
Transmittal form for Nursing Home to submit to HRA: new Medicaid application, request to convert coverage from community Medicaid, upgrade coverage, or notify HRA that transfer penalty period expired. (updated 5/5/2022)
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25 Mar, 2023
69 kb
Downloads: 10140
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Medicaid Household Size Chart for Aged, Blind and Disabled Individuals ("SSI-Related")
HOUSEHOLD SIZE FOR SSI RELATED CHART 2023 (using 2022 FPL).pdf
Updated 2023 using the 2022 FPLs. We hope to update it again when DOH adopts the 2023 FPLS.
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22 Jan, 2023
140 kb
Downloads: 49273
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