Changes in how people apply for and receive Medicaid personal care services occurred in September 2012, followed by major changes for how all people under age 65 applied for Medicaid in 2014, when the NY State of Health Exchange was launched to accept Medicaid applications under the Affordable Care Act.
There are 2 main ways of accessing Medicaid, depending on age, Medicare status, and some other factors.
A. People age 65+ or younger if they are disabled and have Medicare -- they apply for Medicaid at offices of New York City's Medicaid program is run by the Human Resources Administration (HRA) Medical Insurance and Community Services Administration (MICSA).
B. People under age 65 who do not have Medicare, and those who have Medicare and live with and take care of a dependent child or other relative apply on the NYS of Health Exchange.
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There are two networks of offices to apply for Medicaid in the community, depending on whether you are seeking Medicaid for home care (whether through Managed Long Term Care or "Immediate Need" or otherwise for those exempt from MLTC) or NOT seeking home care.
(1) Community Medicaid offices - process applications for Medicaid with a "spend-down," the Medicaid Buy-In
for People with Disabilities, and the Medicare Savings Program
These are for people NOT seeking Medicaid personal care (home attendant) services or the managed long term care program.
Community Medicaid offices do handle and approve supplemental needs trusts.
They do NOT accept applications for nursing home coverage.
(2) Home Care Services Program (CASA) - DO NOT FILE application directly with any CASA office. Instead
A. WHERE TO FILE Medicaid applications for adults age 21+ who have Medicare and who will be seeking Medicaid Managed Long Term Care services:
HRA--HCSP Central Medicaid Unit - MAIL HERE
785 Atlantic Avenue, 7th Floor
Brooklyn, NY 11238 T: 929-221-0849
DURING COVID EMERGENCY MAIL HERE OR FAX TO 917-639-0732
OUTSIDE COVID EMERGENCY - FILE ion the 1st floor WINDOW 16- Recommended that you file it in PERSON and get your copy STAMPED received.
Please see NYC Medicaid Alert dated January 3, 2013 explaining the relocation of the Central Medicaid Unit and other home care services programs within HRA.
B. WHERE TO File Medicaid applications and M11q forms, for those EXCLUDED from Managed Long Term Care and seeking "regular" personal care or housekeeping services --
(3) Hospitals often apply for Medicaid for people admitted for inpatient care. They apply directly to the Hospital Eligibility Unit at the main administrative offices at 785 Atlantic Ave., Brooklyn NY, or through the NYS of Health Exchange.
(4) Nursing Home Medicaid -- Since 2006 changes in the law, you may only apply for Medicaid nursing home coverage once you have been admitted to a nursing home.
For those who did not have Medicaid at all before entering the Nursing Home, or who had Medicaid through the NYS of Health Exchange, or who are in a mainstream Medicaid managed care plan, these applications are filed at the:
If you were in a Managed Long Term Care plan at the time you entered the nursing home, and will be applying for Nursing Home Medicaid, then your Medicaid application is filed with:
HRA--HCSP Central Medicaid Unit
785 Atlantic Avenue, 7th Floor
Brooklyn, NY 11238 T: 929-221-0849
Apply online for Medicaid if you do not have Medicare, or if you have Medicare and have a dependent child or other relative living with you.
Call 1-855-355-5777,visit nystateofhealth.ny.gov or contact NY State of Health Assistor/ navigator to
learn more
The Exchange is for people in the "MAGI" categories - families and children, singles and couples, generally people under age 65 who do not have Medicare. People with disabilities may be MAGI if they do not have Medicare, but may also apply at HRA/DSS Medicaid offices using the old budgeting rules if it is more favorable to them.
Health Care for All New York coalition - interactive Marketplace eligibility questionnaire
Click here for an interactive Marketplace eligibility questionnaire, designed to help enrollment assistors and consumers better assess their potential eligibility for Marketplace coverage based on immigration status, age and income. This questionnaire is not an official assessment of eligibility. To receive an official determination of eligibility contact the New York State of Health Marketplace at http://www.nystateofhealth.ny.gov or 1-855-355-5777
Job Centers - People applying for or receiving cash assistance through the state Safety Net program or Temporary Aid to Needy Families Program may also receive Medicaid and Food Stamps by applying at these centers.
SSI -- Anyone receiving Supplemental Security Income (SSI) benefits, even if only $1 in benefits, automatically receives Medicaid without having to separately apply for Medicaid.
This article was authored by the Evelyn Frank Legal Resources Program of New York Legal Assistance Group.