What You Need To Know

Medicaid has been established with the aim to cater to the medical needs of people in states. It is especially for those people who are unable to provide for their healthcare. Medicaid is designed to pay for the appropriate services required by the person. This includes a variety of treatments but still has its limitations. It is dependent upon various factors such as

  • Age
  • Financial circumstance
  • Family situation
  • Transfer of resource requirements
  • Living arrangements.

Medicaid tries to provide all its qualified members with fully funded services. However, due to limited resources, some services require co-payment. This means that a portion of the bill is undertaken by Medicaid whilst the rest is paid by the patient. The administration of this benefit program has been carried out by the Centers for Medicare & Medicaid Services (CMS). Medicaid provides its services through the help of a Medicaid card or a managed care plan. You have to be enrolled in the latter.

Are You Eligible?

The New York Medicaid program has a certain list of requirements. The basic aspects that need to be fulfilled include:

  • A resident of the state of New York
  • Someone in need of health coverage
  • Someone with low or very low income
  • A U.S. national, citizen, or legal alien.

These are a requirement for most of the benefits program. However, the other more specific criteria outline that the person must

  • Be over 64 years of age, or
  • Be pregnant or a parent of a child under 18, or
  • Be blind or disabled, or
  • Be related to someone who is blind or disabled. The relative can be a child, parent or spouse.

To ensure that the financial situation of the applicant is low enough to qualify for Medicaid, the income is considered. The annual household income is taken into account before any tax deductions take place. The income amount is compared to see whether it is less than or equal to the listed amounts.

Size Of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

If a household has more than eight residents, then an additional amount of $5,878 should be added per person. It is advised to stay in touch with the managing agency of the area. This would help you to remain up-to-date with the latest and more accurate guidelines.

How to Apply

To start the application process, different methods can be used. An eligible person can choose to call the consumer service number for information related to it. This would also allow the person to gain guidance concerning the form. Moreover, they can also approach the local department of social services. With the help of the internet, they can find the nearest agency and choose to go through the procedure in person. Furthermore, the internet can be used for the whole application process. This would help the people to easily access all information from the comfort of their home. The application can be found on the website of the New York State of Health.

There are certain documents required in case one wishes to apply for Medicaid. The documents are dependent on the two kinds of categories that take place in this program. These two are labeled as Modified Adjusted Gross Income (MAGI) guidelines and non-MAGI guidelines. The MAGI Group includes the following eligible people:

  • Pregnant women
  • Children in Foster Care
  • Parents or Caretaker Relatives
  • Infants and children under 19
  • Family planning benefit program
  • Childless adults who are:
  • Not pregnant
  • Aged between 19 and 64
  • Not on Medicare
  • Certified Disabled

On the other hand, Non-MAGI Group includes:

  • Individuals aged 65 or above
  • Individuals who are blind or disabled who do not meet the MAGI group criteria.
  • COBRA
  • Medicare Savings Program – MSP
  • AIDS Health Insurance Program – AHIP
  • Medicaid Buy-In for Working People with Disabilities
  • Medicaid Cancer Treatment Program
  • Residents of Adult Home run by LDSS, OMH Residential Care Centers.

New York Medicaid has made sure to provide the groups with necessary application accessibility options. This makes it more possible for them to acquire and complete it on time. The presence of the form in different languages also helps to cater to a larger audience.

The waiting period between application submission and acceptance or denial is 45 days. In case of pregnancy or children, the period decreases to 30 days instead. However, if the applicant has a disability, this time duration can increase up to 90 days. This is done in order to properly determine the eligibility.

For Further Information

Queries and confusions of the interested individuals can be addressed on the New York Medicaid website. It would allow them to get more in-depth information about the benefits program.

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