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 newest directives scroll to the bottom of this page.

1.     13 ADM-04 - Medicaid Application and Renewal Processing for Modified Adjusted Gross Income (MAGI) Eligibility Groups  (Dec. 4, 2013)  PDF  

2.     13 ADM-03 - Medicaid Eligibility Changes under the Affordable Care Act (ACA) of 2010  (PDF) 

13 ADM-03 describes "expanded Medicaid coverage under the ACA, a new method for counting household income based on modified adjusted gross income (MAGI), Medicaid benefits under the ACA and Medicaid enrollment in New York's Health Benefit Exchange."

The directive contains several attachments, including these desk aids explaining

- MAGI Eligibility Groups and Income Levels (Attachment 1)

- MAGI and Non-MAGI Eligibility Groups  (Attachment 2) and

- the notice to households whose applications are being referred to the local district for non-MAGI processing. (Attachment 3)

3.    GIS 13 MA/021 Renewal Processing for MAGI Eligibility Groups Beginning January 2014 (PDF) (11/15/2013)

4.    GIS 13/MA/022 2014 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards

5.    GIS 14/MA-007   Update on Self-Employment Policy for MAGI-like Budgeting  (3/21/2014)

6.   GIS 14 MA/016: Long Term Care Eligibility Rules and Estate Recovery Provisions for MAGI Individuals

7.   GIS 14 MA/022 - Medicaid Eligibility for Pregnant Minors   PDF  (7/1/2014)

8.     2014 LCM-02 - Medicaid Recipients Transferred at Renewal from New York State of Health to Local Departments of Social Services   (Dec. 1, 2014)

8.  GIS 15 MA/008 - Treatment of Income of Dependents Under MAGI-like Rules  (4/9/2015)

Child's Social Security or other income may be disregarded from household income, depending on amount and type of income.

9.  GIS 15 MA/022 - Continuous Coverage for MAGI Individuals  (12/23/15)   PDF 

Clarifies that "MAGI-like" category -- those who fall into a MAGI category but are getting their Medicaid coverage through their LDSS or HRA -- are entitled to the same 12-month continuous coverage protections as MAGIs (people who fall into a MAGI category and are getting their coverage through the Marketplace).  Some people must get coverage through their LDSS because they need long term care such as home care, a waiver program, or nursing home care.  They are eligible for these services with MAGI eligibility- see GIS 14 MA/016 above- but need eligibility processed by the local district.

10.  GIS 15 MA/020 - IRS Tax Form 1095-B Guidance   PDF  

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Article ID: 193
Last updated: 30 Dec, 2015
Revision: 10
Medicaid -> NYS Directives on Medicaid changes under the Affordable Care Act