We have scoured the internet to provide all you need to know about the New York Medicaid Benefits.
Medicaid is a joint federal-state initiative that covers health insurance for low-income people who qualify, including children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, over the phone, or online.
This post will teach you all you need to learn about Medicaid in New York.
Table of Contents
What is the New York Medicaid Program?
New York Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.
Who is eligible for the New York Medicaid Program?
New York Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.
- Expectant mothers
- People who are blind or disabled or who have a spouse who is blind or disabled;
- People whom someone adopts;
- People whom someone adopted;
- People who are blind or disabled or have a spouse who is disabled.
The Annual Household Income Limits (before taxes)
| Household Size* | The Maximum Income Level (Per Year) |
| 1 | $18,075 |
| 2 | $24,353 |
| 3 | $30,630 |
| 4 | $36,908 |
| 5 | $43,186 |
| 6 | $49,463 |
| 7 | $55,741 |
| 8 | $62,018 |
*For households with more than eight people, add $6,277 per additional person.
How do I contact Medicaid in New York?
[Find it here:https://www.benefits.gov/benefit/1637]
Phone
1–800–505–5678
Mailing Address
New York State Department of Health—Medicaid Managed Care,
eMedNY P.O. Box Rensselaer, New York 12144
Email: spa_inquiries@health.ny.gov.
What are the Medicaid plans in New York?
[You should be able to find the table in this pdf in each state from this website https://www.medicaid.gov/Medicaid/downloads/new-york-mcp.pdf]
Medicaid Managed Care
Medicaid’s Managed Care program offers primary care case management (PCCM) and managed care organizations (MCO) as choices for acute, primary, specialty, limited long-term care, and limited behavioral health.
Managed Long Term Care (MLTC) Programs
Only institutional and community-based long-term services and supports are covered by the Managed Long Term Care (MLTC) program, commonly known as “partial capitation.” In contrast, Medicaid-funded primary and acute care are covered (but excluded) on a fee-for-service basis.
Medicaid Advantage and Medicaid Advantage
The Medicaid Advantage and Advantage Plus programs are only available in a few locations, including New York City.
How do I apply for New York Medicaid?
[Find it here:https://www.benefits.gov/benefit/1637]
Call 1–800–505–5678 to enroll.
Apply in person at New York State Department of Health—Medicaid Managed Care
Online: Download and print the application.
Mail: To eMedNY P.O. Box Rensselaer, New York 12144
Email: spa_inquiries@health.ny.gov.
What is covered by New York Medicaid?
[Find it here:https://www.benefits.gov/benefit/1637]
New York Medicaid covers the following services:
| Ambulatory surgery | Hospital stays |
| Audiology services | Laboratory tests |
| Behavioral health services | Vision care |
| Women’s health care | Non-emergency transportation |
| Dialysis | Orthotic and prosthetic devices |
| Doctor visits | Occupational therapy |
| Smoking cessation services | Pharmacy (medications) |
| Emergency care | Physical rehabilitation |
| Family planning services | Preventive care |
| Hearing aids | Hospital outpatient care |
| Home health care | X-rays and other radiology services |
Can I have both NY Medicaid and Medicare?
Instead of seeking care in a care home or other facility, integrated care plans are intended to assist dual-eligible beneficiaries with meeting their medical needs locally.
New York Waiver
[For more information, please visit https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/NY]
The following are the waivers of New York:
- NY CAH III
- NY CAH VI
- NY Children’s Waiver
- NY Long Term Home Health Care Program
- NY OPWDD Comprehensive Waiver
Copayments?
They do not have to pay a copayment. When a member is
- under 21 years old;
- pregnant;
- Held by the state
- Placed under government supervision
- Native American participants
- Services or Tribal Union of Indian Health Services
- The hospital (inpatient)
- A facility for skilled nursing
- A nursing home
What is not covered by New York Medicaid?
New York Medicaid is not mandated to offer coverage for in-home caregiving services or private nursing. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.
What is the highest income limit for New York Medicaid?
For a single applicant and a couple, the medically necessary income ceiling for 2022 is $934 monthly and $1,367 monthly, respectively.
What if a person’s income is too high to qualify for regular Medicaid benefits?
If your income is too high, you may still be eligible for Nevada Medicaid, thanks to the asset spend down option. Paying down your surplus assets on non-countable ones will allow you to qualify.
What documents do I need to apply for Medicaid?
The following papers are required with the application:
- The Social Security Number;
- Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
- Evidence of all income sources, both legal and illegal
- Proof of origin
- Proof of residency
- Including the Medicare card, any insurance cards
- Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
- When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.
What is the best Medicaid in New York?
The Mid-Atlantic States’ Kaiser Foundation Health Plan, Inc. received the best overall score among Medicaid plans for HPR 2021.
Where do I find the letter showing the reason(s) for denial or discontinuance from New York Medicaid?
By signing into your account at Portal, you can see the progress of your New York Medicaid application.
