Qualifications for Medicaid In NY – How to Apply for NY Medicaid

The New York Medicaid program provides comprehensive health coverage to over 7 million low income individuals and families in the state. It provides a wide range of healthcare services for beneficiaries of different ages, financial situations, family situations, and living arrangements. The state has a large network of healthcare providers for easy access to different types of healthcare services.

This article will discuss the eligibility criteria for New York state Medicaid and how to apply.

Eligibility Criteria for Medicaid in New York

Eligible Groups

NY state Medicaid caters to different groups of people, as follows:

• Low income families. These are families with children under the age of 19 years. It can be single parent households or households with both parents or caretakers
• Adopted children and children in foster care
• 19 and 20-year-olds living alone
• 19 and 20-year-olds living with their parents
• Pregnant women. NY Medicaid covers prenatal care, delivery, and postpartum care for eligible pregnant women
• Persons with disabilities, including those receiving Supplemental Security Income (SSI) and those not eligible for social security benefits
• Seniors. Those aged 65 years and above. They may qualify for Medicaid even if they are on Medicare
• Adults aged 19-64 years who meet the income and asset limits
• Individuals with high medical expenses. Some individuals with high medical expenses may be eligible for Medicaid even if their asset and income limit exceeds the stipulated threshold
• Individuals requiring long-term care services such as home health care and nursing home care

Citizenship and Residency

To be eligible for NY Medicaid, you must be a US citizen or a qualified non-citizen, including lawful permanent residents, e.g., green cardholders. Other qualified non-citizens include asylees, refugees, and others with lawful immigration status.

You must also be a New York resident and intend to continue living there for this health insurance coverage. Your Medicaid qualification will be revoked if you relocate from New York.

Medicaid Income Limits

Medicaid income limits for NY Medicaid qualification depend on your annual income level and household size as follows:

• 1 – person household: $18,075
• 2 – person household: $24, 353
• 3 – person household: $30,630
• 4 – person household: $36,908
• 5 – person household: $43,186
• 6 – person household: $49,463
• 7 – person household: $55,741
• 8 – person household: $62,018

For households with more than 8 people, add $6,277 for each additional person.

Almost all types of incomes count towards the Medicaid income limit, including employment wages, IRA distributions, social security disability income, social security income, gifts, annuity payments, pensions, alimony payments, interests, dividends, royalties, rental income, veteran benefits, unemployment benefits, etc.

The income considered is before taxation. Overall, the allowable income is 138% of the federal poverty level.

Asset Limits

In determining your asset limit for NY Medicaid, assets are classified as either countable or non-countable. Countable assets include stocks, bonds, vacation homes, bank accounts including checking, savings, money market, and any stimulus checks.

Non-countable assets include your primary home, vehicle, burial funds up to $1,500, life insurance policy up to $1,500, and personal belongings.

The assets are assessed jointly for married couples regardless of whether only one spouse is the Medicaid applicant. However, the other spouse is entitled to a community spouse resource allowance to prevent them from becoming impoverished.

There is also a 60-month look back period that aims to discourage asset transfer or gifting by individuals to reach the asset limit. The asset limit for a Medicaid applicant in New York is $30,180 for individuals and $40,820 for couples.

How to Apply for NY Medicaid

There are different ways of applying for NY Medicaid benefits depending on your eligibility group, financial status, and preference.

Children, pregnant women, and most adults under the age of 65 should apply through the NY State Health. On the other hand, seniors aged 65 years and above who are on Medicare or individuals applying for Medicaid based on their disability should apply through the New York City Human Resource Administration (HRA).

The HRA also offers free enrollment assistance for seniors and persons with disability. You can reach them via phone at 347-396-4705 for assistance with enrollment or renewal.

Other alternative ways of applying for New York Medicaid benefits are through the Local New York state Department of Social Services Office or by calling the Medicaid helpline (1-800-541-2831). For more information on the Medicaid application process, visit the New York Medicaid website.

To apply for Medicaid services, it requires the following:

• Documentation showing your citizenship, residency, or lawful immigration status
• Social security number
• Number of people in your household
• Current income information
• Duly filed Medicaid application form
• Documentation for your assets

Conclusion

The NY Medicaid program provides millions of beneficiaries affordable access to comprehensive medical care. Eligible groups include infants, children aged 19 years and below, young adults aged 19 and 20 years living alone or with their parents, adults aged 20-64 years with low income, seniors, and persons with disability.

You must be a US citizen residing in New York to be eligible to become a Medicaid recipient. You must also meet the assets and income limits stipulated for the specific year.

Applications are made through the NY State Health Department, New York City Human Resource Administration (HRA), or New York Medicaid website. You could also apply through the Local Department of Social Services Office or the Medicaid helpline. Be sure to provide the necessary documentation and information to accelerate the approval process.