How to Apply for Medicaid in New York

If you are looking to apply for Medicaid online in New York or through other methods, there are several application guidelines you need to be aware of prior to filing your request. Where to apply for Medicaid in New York differs depending on whether your Medicaid eligibility is classified on your Modified Adjusted Gross Income (MAGI) or other qualifiers (non-MAGI). No matter which eligibility category you fall into, you have multiple approaches for completing the Medicaid application in New York, from fully online models to assisted in-person sessions with a designated navigator of the New York Department of Health. Applying for Medicaid online is always the fastest and most convenient choice for getting claims processed in a timely manner, but there are also multiple layers of other support for applicants who feel more comfortable with paper or assisted formats. Even many years prior to the passage of the Affordable Care Act, New York helped make health care attainable to low-income residents. Because of its participation in the expansions provided by adoption of the Affordable Care Act, the process of how to apply for Medicaid in New York has become a much easier question to answer for needy residents.

Where do you sign up for Medicaid in New York?

Much of how to apply for Medicaid in New York rests on which category of coverage you are applying for. The Medicaid application form is processed differently for MAGI and non-MAGI applicants. There are essentially five methods of application. You can apply through:

  • The New York State of Health’s Official Health Plan Marketplace.
  • Navigators and Application Counselors
  • Managed Care Organizations.
  • Medicaid Helpline telephone number.
  • New York District Social Service Offices.

Your Medicaid application in New York can be filed online, via mail, over the phone or with a certified application counselor in person at the aforementioned physical locations. For expedient results with your Medicaid application form, choose a method of applying that you find simple and convenient to your schedule and individual needs. The Department of Health suggests that if you are a parent or caretaker relative, pregnant woman, child between the ages of one and eighteen years of age or an adult between the ages of 19 and 64 who is not pregnant and not eligible for Medicare, your best option is to apply in the NY health insurance Marketplace. By contrast, your Medicaid application form is best filed at the Local Department of Social Services (LDSS) if you are former foster care youth, a nursing home resident or a participant in Medicare Savings Program. Additionally, this method of Medicaid application is applicable to those who are blind or disabled and applying for long-term care or are a person older than 65 years of age who is not a parent or a related caretaker. The parent or caretaker relative can apply for Medicaid through the LDSS if age is a condition of eligibility. Applying for Medicaid in either MAGI or non-MAGI categories utilizes a separate, printable form and may require various supplemental pieces of documentation per individual circumstances. Special versions of the New York Medicaid application are available for applicants who may have visual impairment or need to view the application in a language other than English.

What information is needed to complete a Medicaid application form in New York?

No matter where you sign up for Medicaid in New York, you will be asked to provide a great deal of personal information pertaining to your finances, health and family members to help determine your Medicaid eligibility. Your Medicaid application will require you to supply your full legal name, current address with valid telephone number, verified Social Security Number, email address, bank account information and medical history documentation. If you have a disability, you will need to provide medical proof of your disabilities and diagnoses with treatment histories.

To apply for Medicaid online or otherwise in New York as a legal immigrant, you will be asked to provide your valid alien number and any associated paperwork detailing your legal citizenship status. Remember that you can only apply for New York Medicaid if you are a New York resident and you must prove New York residency. Be prepared to list assets, for every member of your household, including yourself. Most Medicaid applications in New York are required to show a minimum of four weeks’ worth of pay stubs to help establish overall financial need. When you sign up for Medicaid, the New York Department of Health defines resources as salary or cash at hand and includes items such as real estate, promissory notes, life insurance policies and even imminent inheritances. To learn more about national requirements for applying for Medicaid, download our free guide to Medicaid today.

For New York residents seeking knowledge about how to apply for Medicaid specifically for nursing home facilities, a lookback period is imposed as part of the application process. During this lookback period of your Medicaid application, the New York Department of health can impose penalties if it finds that assets have been recently transferred for less than fair market value. This process is implemented to make sure that Medicaid benefits go to the right recipients, so you must ensure that your responses to questions about your family assets are accurately answered throughout your Medicaid application process. Anyone applying for Medicaid must make sure to accurately report all details, including income, to make sure they receive the best Medicaid cost and coverage options possible.

Additional Tips for the Medicaid Application in New York

In order for some New York petitioners to successfully file a Medicaid application form, they must first apply for Medicare. The Medicaid application is contingent on pre-filing for Medicare for two main subgroups of New York applicants. These two subgroups consist of people who are 65 years of age or will be within the next three months and fall beneath a set percentage of the Federal Poverty Level. Other who are eligible to apply for Medicaid through Medicare are those with Amyotrophic Lateral Sclerosis (ALS) or Chronic Renal Failure, regardless of income. Medicare is a specialized condition of eligibility for Medicaid for these two groups of applicants and applying for Medicaid can take longer if you fall into one of these categories and do not already have Medicare coverage. If you have achieved both Medicare and Medicaid coverage, Medicare pays your medical bills first and any leftover difference in balance due is forwarded to Medicaid. Unlike the Medicaid application form, Medicare is managed solely via the Social Security Administration and that is the organization to which you must apply for Medicare first if you are part of the aforementioned subgroups.

For further details on how to apply for Medicaid, download our comprehensive Medicaid guide today.