How to apply for Medicaid in New York FAQ
It’s ok to have questions
Applying for Medicaid can be frustrating. We are here to help! Follow our step–by-step FAQ guide to apply to get coverage for your Home Care Services.
The New York State Department of Health determines eligibility using Modified Adjusted Gross Income (MAGI) Rules. In general, income is counted under the same rules as those of the Internal Revenue Service (IRS), with minor variations. Individuals in the MAGI eligibility groups listed below should apply through the NY State Department of Health.
You may be eligible if you are:
- An adult aged 19–64 (who is not eligible for Medicare)
- A child of 1-18 years of age
- An infant under the age of one
- A pregnant individual
Individuals who are part of the non-MAGI eligibility groups listed below should apply with their Local Department of Social Services (LDSS) or a Facilitated Enroller for the Aged, Blind, and Disabled.
Non-MAGI eligible groups:
- Individuals of 65 years of age and older
- Individuals who are blind or disabled who do not meet the criteria of MAGI eligibility groups, including those individuals with an immediate need for Personal Care Services (PCS) or Consumer Directed Personal Assistance Services (CDPAS).
- Social Security recipients
- Residents of Adult Homes run by LDSS, OMH, Residential Care Centers/Community Residences
- Individuals eligible for the following programs:
- Medicare Savings Program (MSP)
- COBRA
- AIDS Health Insurance Program (AHIP)
- Medicaid Buy-in Program for Working People with Disabilities
- Foster care and former foster youth
- Individuals screened for Presumptive Eligibility (PE) with a provider
Other factors that may affect your eligibility include: State Residence, Citizenship or Immigration Status, Family or Household Size, or Income.
You will need to prepare the following documents for your Medicaid application:
- Proof of identity (ID, birth certificate, etc)
- Proof of citizenship or immigration status
- Proof of residency (NY address)
- Income verification (pay stubs, tax returns)
- Asset documentation for seniors/disabled (bank statements, property info)
You may apply for NY Medicaid in the following ways. CHCA will be here to support you through the process:
- Through NY State of Health: The Official Health Plan Marketplace
- Enrollment Assisters offer free personalized help
- To speak with the Marketplace Customer Service Center, call (855) 355-5777 (TTY: 1-800-662-1220).
- Through a Managed Care Organization (MCO)
- Call the Medicaid Helpline at (800) 541-2831
- Call the Medicaid Helpline at (800) 541-2831
- Through your Local Department of Social Services Office
- Wait for processing. New York City Health Resources Administration or the county Department of Social Services reviews it within standard time frames, as little as 12 days, or it may take longer. You will get an approval or denial notice by mail or online.
- Choose a Managed Care Plan. If your application is approved, you will need to choose a managed care plan (MCO). CHCA can help you select a health plan that works for you.
- Use your coverage. Upon activation, you’ll receive a Medicaid ID card and MCO card. Now you can start using your short- or long-term care services.
- Renew your coverage. Medicaid coverage must be renewed annually. You’ll receive reminder notices (ACCESS HRA, mail, or online alerts in your account) NYC.gov.