Sunday, October 20, 2013

How do I apply for Medicaid in New York City?

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    • Questions

    How do I apply for Medicaid?

    You can apply for Medicaid in any one of the following ways:

    Medicaid in New York State

    For current Medicaid beneficiaries:
    For those subject to a resource test:

    What is Medicaid?

    Medicaid is a program for New Yorkers who can't afford to pay for medical care.

    How do I know if I qualify for Medicaid?

    You may be covered by Medicaid if:
    • You have high medical bills.
    • You receive Supplemental Security Income (SSI).
    • You meet certain financial requirements.
    For more details, use the ACCESS NY Public Health Insurance Eligibility Screening Tool to see which public health insurance programs you and your family may be eligible for.

    How do I apply for Medicaid?

    You can request an application for Medicaid by phone, by mail or in person through your local department of social services (LDSS) or by contacting a Facilitated Enroller (FE).
    An FE is a community agency trained to assist with Medicaid applications. An FE may have hours or a location that is more convenient than the LDSS. They are available to provide application assistance but you do not have to use an FE in order to apply. Individuals who are over the age of 65, certified blind or disabled, not certified disabled but chronically ill, or in need of Medicaid coverage of nursing facility services, should go to an LDSS not an FE. To locate an FE in your area, go to: http://www.nyhealth.gov/nysdoh/fhplus/apply/application_centers.htm.
    You can also use the "Fill and Print" ACCESS NY Health Care application to apply for Medicaid. With the "Fill and Print" ACCESS NY Health Care application, you can fill out the application on your screen and print the completed form. Once printed, you will need to mail it or bring it to your local DSS/HRA office. Please note that if you choose to use the "Fill and Print" ACCESS NY Health Care application, you will not be able to save the information you typed into the application to your computer.
    Applications and assistance in filling them out can also be obtained by calling New York Health Options at 855-693-6765.
    In New York City, applications can be obtained by contacting the Human Resources Administration (HRA) at (718) 557-1399.
    Residents of New York City can mail applications to the Human Resources Administration at:
    Initial Eligibility Unit
    HRA/Medical Assistance Program
    P.O. Box 2798
    New York, NY 10117-2273
    Pregnant women and children can apply at many clinics and hospitals. Contact your local department of social services to find out where you can apply.
    If you are in a facility operated by the New York State Office of Mental Health, contact the Patient Resource Office.
    If you are in a facility certified by the New York State Office for People With Developmental Disabilities, contact the Revenue Support Office.
    You no longer need to have a personal interview to be eligible for Medicaid. If you need help with understanding and filling out your application, you can call or visit your local department of social services or a facilitated enroller. You can also call New York Health Options at (855)693-6765.
    For more details, use the ACCESS NY Public Health Insurance Eligibility Screening Tool to see which public health insurance programs you and your family may be eligible for.

    What do I need to apply for Medicaid?

    • If you are a U.S. citizen (born in the U.S. or one of its territories) and provide a valid
      Social Security Number (SSN), a match with Social Security Administration (SSA) will
      verify your SSN, date of birth/age and U.S citizenship. If SSA verifies this information,
      no further proof is needed. The SSA match cannot verify birth information for a naturalized citizen.
      You will need proof of naturalization (e.g., Naturalization Certificate (N-550 or N-570) or a U.S. passport).
    • Proof of age (if not verified by SSA), like a birth certificate
    • Proof of citizenship or immigration status*
    • Four weeks of recent paycheck stubs (if you are working)
    • Proof of your income from sources like Social Security, Supplemental Security Income (SSI), Veteran's Benefits (VA), retirementUnemployment Insurance Benefits (UIB), Child Support payments
    • If you or anyone who lives with you is 65 years old or older, certified blind or disabled, you need to provide information on bank accounts, insurance policies and other resources.
    • Proof of where you live, like a rent receipt, landlord statement, mortgage statement, or envelope from mail you received recently
    • Insurance benefit card or the policy (if you have any other health insurance)
    • Medicare Benefit Card (the red, white and blue card)
    *NOTE: Medicaid coverage is available, regardless of alien status, if you are pregnant or require treatment for an emergency medical condition. A doctor must certify that you are pregnant or had an emergency, and you must meet all other Medicaid eligibility requirements.

    If I think I am eligible for Medicaid, should I cancel any other health insurance I might already have?

    No. If you currently pay for health insurance or Medicare coverage or have the option of getting that coverage, but cannot afford the payment, Medicaid can pay the premiums under certain circumstances.
    Even if you are not eligible for Medicaid benefits, the premiums can still be paid, in some instances, if you lose your job or have your work hours reduced. If you need help with a COBRA premium, you must apply quickly, to determine if Medicaid can help pay the premium.
    You may be eligible for the Medicare Savings Program. This program pays your Medicare premiums and deductibles.
    If you have Acquired Immune Deficiency Syndrome (AIDS), Medicaid may be able to help pay your health insurance premiums.

    How do I know if my income and resources qualify me for Medicaid?

    The chart below shows how much income you can receive in a month and the amount of resources (if applicable) you can retain and still qualify for Medicaid. The income and resource (if applicable) levels depend on the number of your family members who live with you.
    2013 Income & Resource Levels*
    Medicaid Standard for Singles
    People, Couples without
    Children & Low Income
    Families    		Net Income for Families; and Individuals who
    are Blind, Disabled or Age 65+    		Resource Level
    (Individuals who are Blind, Disabled or Age 65+ ONLY)
    AnnualMonthlyAnnualMonthly
    1$8,994$750$9,600$800$14,400
    2$11,228$936$14,100$1,175$21,150
    3$13,360$1,114$16,215$1,352$24,323
    4$15,512$1,293$18,330$1,528$27,495
    5$17,737$1,479$20,445$1,704$30,668
    6$19,364$1,614$22,560$1,880$33,840
    7$21,078$1,757$24,675$2,057$37,013
    8$23,278$1,940$26,790$2,233$40,185
    9$24,538$2,045$28,905$2,409$43,358
    10$25,800$2,150$31,020$2,585$46,530
    For each additional person, add:$1,262$106$2,115$177$3,173
    *Effective January 1, 2013
    For more details, use the ACCESS NY Public Health Insurance Eligibility Screening Tool to see which public health insurance programs you and your family may be eligible for.
    Income and Resource Levels are subject to yearly adjustments.
    You may also own a home, a car, and personal property and still be eligible. The income and resources (if applicable) of legally responsible relatives in the household will also be counted.

    Can I be eligible for Medicaid even if I make more money than the chart shows?

    Yes, some people can. Pregnant women, children, disabled persons, and others may be eligible for Medicaid if their income is above these levels and they have medical bills. Ask your Medicaid worker if you fit into one of these groups.
    Click here for more information on the Medicaid Excess Income program.
    Individuals who are certified blind, certified disabled, or age 65 or older who have more resources may also be eligible. Ask your Medicaid worker if this applies to you.
    If an adult has too much income and/or resources and is not eligible for Medicaid, that person may be eligible for:

    Expanded Income levels for Children and Pregnant Women

    • Infants to age one and pregnant women - 200% of the federal poverty level.
    • Children age 1 through 18 years - 133% of the federal poverty level.
    Monthly Income Effective January 1, 2013*
    Number in Family133% FPL**200% FPL**
    1$1,274$1,915
    2$1,720$2,585
    3$2,165$3,255
    4$2,611$3,925
    5$3,056$4,595
    6$3,502$5,265
    7$3,947$5,935
    8$4,393$6,605
    For each additional person, add:+$446+$670
    * Income Levels are subject to yearly adjustments.
    ** FPL = Federal Poverty Level
    If a child has too much income and is not eligible for Medicaid, the child may be eligible for Child Health Plus.
    You also can use the ACCESS NY Public Health Insurance Eligibility Screening Tool to see which public health insurance programs you and your family may be eligible for.
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