Applying For Medicaid

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? Full information is available here:
You may be covered by Medicaid if:
•You have high medical bills.
•You receive Supplemental Security Income (SSI).
•You meet certain financial requirements.
How do I apply for Medicaid?

You may apply for Medicaid in the following ways:
•NY State of Health, The Official Health Plan Marketplace (855)355-5777
•Online website
•Managed Care Organization (MCO)
•Navigators and Certified Application Counselors
•Medicaid Helpline (800)541-2831
•Local District Social Services Offices
Where you apply for Medicaid will depend on your category. Your category might be single, childless couples, pregnant women, parent(s) and caretaker relatives with dependent children, elderly and/or disabled.
The Marketplace determines eligibility using Modified Adjusted Gross Income (MAGI) Rules. In general, income is counted with the same rules as the Internal Revenue Service (IRS) with minor variations. Applications may be completed online, in person with a navigator or certified application counselor, by mail and by phone.
The following individuals should apply with New York State of Health Marketplace:
•Adults (not pregnant) and aged 19-64, not eligible for Medicare;
•Pregnant Women and Infants;
•Children ages 1 – 18; and
•Parents and Caretaker Relatives
The following individuals should apply with their Local Department of Social Services (LDSS):
•Individuals in receipt of Temporary Assistance for Needy Families (TANF);
•Individuals in receipt of Supplemental Security Insurance (SSI);
•Foster Care youth;
•Individuals age 65 and older, who are not parents or caretaker relatives, when age is a condition of eligibility;
•Individuals whose eligibility is based on being blind or disabled or who request coverage for community based long term care (CBLTC) services;
•Medicare Savings Program (MSP);
•Medicaid Buy-In for Working People with Disabilities enrollees (MBI-WPD);
•Former Foster Care youth;
•Residents of adult homes and nursing homes;
•Residential treatment center/community residences operated by The Office of Mental Health (OMH) and;
•Presumptive Eligibility (PE) for Pregnant Women apply with provider, processed by the LDSS.
What do I need to apply for a job in the UK with Medicaid?
The necessary documentation needed to apply for Medicaid will depend on your category, whether you fall under the Modified Adjusted Gross Income (MAGI) guidelines or non-MAGI guidelines which are defined in the previous section.
MAGI Eligibility Groups include:
• Pregnant Women
• Infants and Children under age 19
• Childless Adults to include individuals who are: not pregnant, age 19-64 (age 19 – 20 living alone), not on Medicare, and could be certified disabled but not on Medicare
• Parents/Caretaker Relatives
• 19 & 20 year olds living with parents
• Family Planning Benefit Program
• Children in Foster Care (Chafee)
Non – MAGI Eligibility Groups include:
• SSI recipients
• Individuals who are age 65 or older, unless a parent/caretaker relative, blind or disabled and do not meet the criteria of the MAGI Eligibility Groups
• Medicare Savings Program (MSP)
• AIDS Health Insurance Program (AHIP)
• Foster Care and Former Foster Care
• Medicaid Buy-In for Working People with Disabilities
• Medicaid Cancer Treatment Program
• Residents of Adult Home run by LDSS, OMH Residential Care Centers/Community Residences
Application for Non-MAGI
The following paper application may only be printed and completed if you are applying at a local department of social services (LDSS) for Medicaid because you are over the age of 65 or an individual in your household is deemed certified blind or disabled or you are applying for Medicaid with a spenddown.
•English, Spanish, Chinese, French, Haitian Creole, Italian, Korean, Russian
•English, Spanish, Chinese, French, Haitian Creole, Italian, Korean, Russian
Documents Needed When You Apply for Health Insurance
•English, Spanish, Chinese, French, Haitian Creole, Italian, Korean, Russian
Fact Sheet
•English, Spanish, Chinese, French, Haitian Creole, Italian, Korean, Russian
Supplement A
•English, Spanish, Chinese, French, Haitian Creole, Italian, Korean, Russian
If you qualify under a MAGI eligibility group, you will have to provide documents to verify eligibility if necessary.
•If you are applying for Medicaid through New York State of Health, the New York State Marketplace, you may attest to your household income for the upcoming year. If your income is different than the income found on the data matches, income documentation may need to be provided.
•Citizenship/Immigration status and social security number will be verified through the federal data sources. If citizenship/immigration status or social security number does not match, documentation must be provided.
If you qualify under a non-MAGI eligibility group, the following is a guide to the documentation that must be submitted to help determine eligibility:
•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 the Social Security Administration (SSA) will verify your SSN, date of birth 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 to submit proof of naturalization (e.g., Naturalization Certificate (N-550 or N-570) or a U.S. passport.
•Proof of citizenship or immigration status*
•Proof of age (if not verified by SSA), like a birth certificate
•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), retirement benefits, Unemployment Insurance Benefits (UIB), Child Support payments
•If you are age 65 or older, or certified blind or disabled, and applying for nursing home care or need coverage for waivered services, you need to provide information on bank accounts, insurance policies and other resources
•Proof of where you live, such as 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 and you 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.
The Medicaid for Income Level for Single People and Couples without Children will be updated for the 2015 level with the release of the 2015 Federal Poverty Levels.