New York Medicaid Application

As of June 2015, the average monthly enrollment in the New York Medicaid program reached 6,441,902. The state of New York chose to make its own health benefits exchange situated at the NY State of Health website. Before the execution of the Affordable Care Act, New York was ahead of the medical insurance market concerning coverage for residents.

The health benefits market was created in 2012 by Governor Andrew Cuomo. Prior to the beginning of the state-funded market, the country ran Family Health Plus. This strategy was aimed toward providing health insurance coverage for low income adults residing in the state of New York. The state has expanded its Medicaid program since its beginning, covering hundreds of thousands more New Yorkers as a result.

What’s Covered Under Medicaid

• Smoking cessation help for pregnant women is offered to offer guidance in stopping smoking.
• Rehabilitation services are offered for men suffering from substance abuse difficulties.
• Dental and dental surgery providers provide participants the ability to find a dentist for routine care and surgical implants or extractions as needed.
• Prescription drug services are provided to participants if the doctor believes that medicine is the appropriate method of treatment.
• Products covered include dental instruments like dentures, hearing aids, eyeglasses, durable medical equipment, and prosthetics.
• Ambulance and non-emergency services are provided to transport participants to hospitals and doctors’ appointments.
• Home health services give in-home services to participants who might be not able to attend doctors’ appointments.
• Hospice care is offered to individuals that are at the end of their lives, need relaxation, and pain management care.

Who’s Covered Under Medicaid

• Adults who receive incomes of around 138 percent of the federal poverty level are eligible to receive Medicaid coverage.
• Pregnant women and babies whose household income doesn’t exceed 218 percentage of the federal poverty level are eligible for coverage under the program.
• For kids in New York, CHIP is another program which allows participation for children whose family income doesn’t exceed 400 percent of the federal poverty level.

For persons that are unsure if they’re eligible for New York Medicaid coverage, an application could be state to the state to determine eligibility. Qualification is largely based on income level since it pertains to the national poverty level.

Persons seeking to apply for Medicaid coverage may use the state’s site at NY State of Health. For people who would prefer to apply by phone, calling 855-355-5777 can connect them to the official market to be able to apply. Assistance is also available if an individual needs local aid in going through the application procedure. Moreover, a local office for your Department of Social Services might be called for additional application assistance.

After the Medicaid Application

After applying to the Medicaid program, local offices will each determine the candidate’s eligibility for coverage. The procedure may take 45 days to offer an acceptance or rejection, normally. Pregnant women or persons applying on the benefit of children may obtain an application decision within 30 days. Applications involving disabilities may require up to 90 days for a complete review.

Eligible parties will be given a letter telling them of the acceptance or rejection for New York Medicaid coverage.

Hearings on the Application Procedure

Hearings may be requested by phone at 800-342-3334, by facsimile at 518-473-735, by using an online form, or by sending a letter to the following address:

PO Box 1930

Additional Information

For authorized participants in the Medicaid program, co-payments do apply for a variety of services. In New York, co-payment amounts may not exceed an aggregate total of $200.00 at any given calendar year. For participants that have exceeded this amount, a letter will be sent explaining they’re exempt from additional co-payments before April 1st.

Participants may be asked to join a Managed Care Plan that covers lots of the advantages used under the Medicaid program. Upon joining a Managed Care Plan, participants are expected to pick a personal physician who will become the responsible party for ensuring that the patient’s medical needs are met. For additional services, the doctor may refer the patient to another physician or specialist.