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NYC HRA Medicaid Form MAP-3062a Request for a Time Extension (12/5/17)(fillable) Download
MAP-3062a Request for a Time Extension (12-5-17) Fillable.pdf
Used for applications, renewals, and the new requirement to apply for Medicare for those age 65+. "I am unable to provide the documentation that HRA requested at this time. I am requesting additional time past the deferral due date that HRA provided. I understand that this extra time may delay the final processing of my case which could result in an eligibility determination taking longer than the normal case processing timeframe of 30 days for a case containing a child, 45 days for a case containing adults only, or 90 days for a case based on a disability." Asks to specify if this is initial extension request or later. This is a fill-in-able form.
11 Jan, 2018 66 kb Downloads: 129
NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2017 Download
2001_to_2017_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2017. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
03 Jan, 2018 3.14 mb Downloads: 251125
Medicaid income and resource levels - 2018 Download
2017-12-29 2018 NYS Medicaid Income and Resource Standards.pdf
NYC HRA Form MAPDR-01
2018 NYS Income and Resource Standards and Federal Poverty Levels (FPL)
Dated 12/28/2017. Still has 2017 Federal Poverty Levels for MAGI limits, MBI-WPD, MSP, etc. until 2018 levels are announced in April 2018
03 Jan, 2018 195 kb Downloads: 307633
NYC HRA Insert to Medicaid Applications and Renewals - Must Apply for Medicare (MAP 3134e) Download
MAP3134e - DAB insert renewal and apply for Medicare (1-20-17).pdf
Insert in all Medicaid renewals and applications informing people age 65+ or approaching age 65 that they must apply for Medicare. Notice does NOT say they need only apply if they meet Medicare immigration status requirements and have incomes under 120% FPL.
22 Dec, 2017 393 kb Downloads: 60
NYC HRA Medicaid Alert 2017-12-04 - Application Dates and Deferral Timeframes Download
2017-12-04 Medicaid Application Dates & Deferral Timeframes.pdf
NYC HRA Medicaid program Alert giving new timeframes for applicants to respond to "deferrals" by the Medicaid agency, which allow additional time to submit missing timeframes. Also introduces a new Form MAP-3062b Decision on your REquest for a Time Extension. MAP-3062a Request for Time Extension is revised 12/5/17 (also posted on this site)
21 Dec, 2017 174 kb Downloads: 49
NYC HRA Medicaid Alert 2017-12-13 Most Medicaid Recipients & Applicants Must appy for Medicare Download
2017-12-13 - Must Apply for Medicare.pdf
Alert issued to implement State policy -- 17 OHIP ADM-01: "Medicare Enrollment at Age 65" -- that requires those with incomes under 120% of the Federal Poverty Line, who are age 65+ or within 3 months of turning 65 - to apply for Medicare, if they would meet the immigration status requirements (citizens or have been a lawful permanent resident for 5 years).

SEe http://www.wnylc.com/health/entry/185/
21 Dec, 2017 139 kb Downloads: 101
MAP-751K Consumer Request to Change Information on File Download
MAP-751K - Consumer request to change info on file.pdf
NYC HRA Form to use any time notifying HRA of change or requesting a change in budgeting. Use for requesting Special Income Disregard for Housing, Spousal Impoverishment budgeting, Pooled Trust budgeting, etc.
04 Dec, 2017 495 kb Downloads: 138
NYC HRA Medicaid Alert 2017-07-26 Power of Attorney and Statutory Gift Rider Download
2017-07-26 Power of Attorney and Statutory Gifts Rider.pdf
"...[T]he New York Statutory Short Form Power of Attorney (NYSPOA), if executed after Sept. 1, 2009, may only be used to establish a trust, if section (h) of the NYSPOA is initialed and if a Statutory Gifts Rider (SGR) is also signed and witnessed by two persons, who are not named in the SGR as permissible recipients of gifts, at the same time as the referencing NYSPOA."
16 Aug, 2017 74 kb Downloads: 620
NYC HRA Medicaid Alert 2017-05-11 New Renewal Form for Disabled/Aged/Blind (DAB) Medicaid Download
2017-05-11 Revised DAB Renewal Form and Online Reprints of DAB Renewal.pdf
Announces new mail renewal form and that DAB renewals will be made available for reprint on ACCESS NYC. Users can go to www.nyc.gov/accessnyc. Reminder that renewals must be signed, and updates should be indicated or check "no change."
16 Aug, 2017 755 kb Downloads: 204
NYC HRA Medicaid Alert 2017-04-26 Change in Medicaid Transportation Contractor in NYC for Medicaid Managed Care and Fee for Service Medicaid Download
2017-04 Medicaid Alert re Transportation for FFS and MMC New Company.pdf
Announces change effective April 23, 2017 from LogistiCare to MAS - Medical Answering Services LLC, the same contractor handling much of upstate NYS.
08 Jun, 2017 192 kb Downloads: 378
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