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Financial Eligibility
Attestation for Immediate Need PCS and CDPAS - 16 ADM 02 Attachment Download
16adm2att.pdf
04 Aug, 2016 299 kb Downloads: 860
Immediate Need for PCS and CDPAS 16 ADM 02 Download
16adm2.pdf
04 Aug, 2016 324 kb Downloads: 1427
Sample Application for Medicaid or MSP - Disabled/Aged 65+/Blind "Non-MAGI" - Download
Medicaid Application Guide with Sample Bank Statement.pdf
Sample Medicaid application completed, with sample bank statement to show how to prove resources are within Medicaid limits
11 May, 2016 2.29 mb Downloads: 2593
Medicaic Household Size Chart for Aged, Blind and Disabled Individuals ("SSI-Related") Download
HOUSEHOLD SIZE FOR SSI RELATED CHART2016_160511180307.pdf
11 May, 2016 132 kb Downloads: 34245
Statement of NYLAG on 2016 NYS Budget Proposals to Eliminate Spousal Refusal and Reduce Spoual Impoverishment Protections Download
NYLAG Spousal Protections 2016.pdf
Statement of NYLAG on 2016 NYS Budget Proposals to Eliminate Spousal Refusal and Reduce Spoual Impoverishment Protections
04 Feb, 2016 385 kb Downloads: 762
NYLAG Testimony on NYS Budget 2016-17 - Medicaid and Health Access Issues Download
NYLAG Health Testimony 2016-2017.pdf
Testimony of NYLAG to the New York State Legislature Joint Hearing of the Senate Finance and Assembly Ways and Means Committees - January 2016
04 Feb, 2016 480 kb Downloads: 433
Fact Sheet & Form for Keeping SSI for 90 Days in Temporary Hospital or Nursing Home Placement Download
Temporary SSI in Nursing Home or Hospital - Fact Sheet and Form Request.pdf
This fact sheet explains requirements for maintaining SSI (Supplemental Security Income) for up to 90 days during a temporary hospital or nursing home stay. The PDF also includes a form for requesting continuation of SSI benefits, which must be filed with the Social Security Administration within strict timelines. NYS SSA office contacts also listed. Note that if SSI benefits are terminated, Medicaid will also be terminated, after "Stenson" notices are mailed giving the recipient an opportunity to recertify for Medicaid without SSI. See http://www.wnylc.com/health/entry/85/
22 Nov, 2015 352 kb Downloads: 3597
NYC MICSA Alerts 8/31/15 & 5/18/15 re Payment of Surplus Bills or Pay-in by Third Parties Download
2015-08-31 Mailing of Notices to Excess Income Consumers re 3rd party payment of surplus.pdf
Both Alerts in one PDF with accompanying Form MAP-3107A Attestation of Use of Recipient Funds
22 Nov, 2015 506 kb Downloads: 4039
NYC HRA Medicaid MICSA Alert June 3, 2015 - Treatment of Income of Dependents for MAGI-Like Budgeting Download
2015-06-03 Treatment of Income of a Dependent under MAGI-Like Budgeting Rules.pdf
Implements NYS DOH GIS 15 MA-08 which clarified that child dependents' Social Security or other income should not be counted in MAGI-like budgeting, which local districts must do when a person eligible under the MAGI category needs long term car and some other instances, for which eligibility must be processed by the local district rather than the Exchange.
22 Nov, 2015 207 kb Downloads: 901
MAP-648 P SUBMISSION OF REQUEST FROM RESIDENTIAL HEALTH CARE FACILITIES (RHCF) Download
MAP-648P NH MA Transmittal 6-2015.pdf
Transmittal form used by HRA Medicaid where the Nursing Home provides HRA with streamlined information about the applicant and the applicant's request for Nursing Home Medicaid coverage.
18 Jun, 2015 147 kb Downloads: 3951
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