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Financial Eligibility
MAP-2161 - Spousal / Parental Refusal Form Download
MAP-2161 Spousal Refusal combined.pdf
Applicants for Medicaid in New York City can use these forms to indicate the refusal of their legally responsible relative to make available their income or resources for the cost of necessary medical care and services, i.e. "spousal/parental refusal." Rev. 12/6/2011 & 3/13/2013
17 Dec, 2013 172 kb Downloads: 39941
Medicaid Resource Disregards Download
ResourceDisregards.pdf
This table lists all of the types of resources (aka, assets) that are excluded for purposes of Medicaid eligibility, including which Medicaid categories they apply to, and citations to authority.
Do not use for MAGI Medicaid effective 1/1/2014.
Updated 10/7/2013.
07 Oct, 2013 66 kb Downloads: 33529
Medicaid Income Disregards Download
IncomeDisregards.pdf
This table lists all of the different sources of income that are excluded from countable income for Medicaid purposes, indicating which categories of Medicaid the exclusion applies to and citations to authority.
Note: do not use for MAGI Medicaid eligibility effective 1/1/2014.
Updated 10/7/2013.
07 Oct, 2013 106 kb Downloads: 90073
NYC HRA - Explicacion del Surplus Income Program - Spanish Download
MAP-931(S) Surplus Income Spanish 2011-08-02.pdf
Document MAP 931 (S)(Spanish) explaining Surplus Income Program, dated 8/2/2011
21 May, 2013 32 kb Downloads: 2283
Social Security Verification--No Proof of SSA Income Required for Initial Applications and Renewals Download
Medicaid Alert No Proof of SSA income required 3-2013.pdf
07 Mar, 2013 337 kb Downloads: 4377
MAPDR-71 2013 Eligibility Level Supplement to MAPDR-01 Download
MAPDR - 71 Eligibility Level Supplement 2013.pdf
Disabled Adult Child, Congregate Care, Supplemental Security Income, and Substantial Gainful Activity Levels
10 Jan, 2013 337 kb Downloads: 1656
Relocation of HRA Home Care Services Program Relocation Download
2013-01-03 HCSP Relocation.pdf
HRA Home Care Services Program had been located at 109 East 16th Street, NY, NY 10003.

Effective January 14, 2013, HRA Home Care Services program will be relocated to:
785 Atlantic Avenue, 7th Floor
Brooklyn, NY 11238
09 Jan, 2013 317 kb Downloads: 3317
HRA MICSA ALert 11-13-2012 - UPDATE: Temporary Location of DARB (Pay-In Program for Spend-down) Download
2012-11-13 - Sandy Relocate DARB Pay-In AMENDED.pdf
HRA MICSA ALert 11-13-2012 - UPDATE: Temporary Location of DARB (Pay-In Program for Spend-down) -- after Hurricane Sandy, couldn't send pay-in payments to 180 Water Street. This reinstates mailing to that address even though office not yet open.
14 Nov, 2012 261 kb Downloads: 655
HRA NYC Medicaid - Temporary Change in Where to "Pay-In" Excess Income - Hurricane Sandy Download
2012-11-07 - Sandy Relocate DARB Pay-In.pdf
MICSA Alert Dated 11/8/12 giving instructions on where to personally bring, not mail Pay-In Payments... per Hurricane Sandy
08 Nov, 2012 316 kb Downloads: 618
HCSP Central Intake Medicaid Unit HRA Download
HCSP Central Medcaid Unit HRA.pdf
This letter is from HRA and it provides information about the process for filing new Medicaid applications for individuals who will be seeking personal care services.
27 Sep, 2012 611 kb Downloads: 711
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