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Medicaid Eligibility & New York

New York's Medicaid program, administered by the state's Department of Health, assists New Yorkers who are unable to pay for their medical care. The program generally covers costs such as health and dental care treatment and preventative care services, in and outpatient hospital services, family planning services, and medications.

  1. General Eligibility Requirements

    • Generally, low-income families and individuals, persons receiving Supplemental Security Income, and those receiving cash assistance are automatically eligible for New York's Medicaid program. Children under 21, individuals over 65, pregnant women and persons with disabilities may also be eligible for Medicaid depending on their income level.

    Income and Resources

    • As of Jan. 1, 2011, the Medicaid income level for a single person without a child is $708 per month. Additionally, the individual may have a house, a car and personal property and still qualify for Medicaid. For an individual that is blind, disabled or over the age of 65, the monthly maximum income is $767; the individual may also have resources of up to $13,800. Income and resource levels are adjusted annually.

    Excess Income Applicants

    • Where an applicant's income exceeds the level to qualify for Medicaid, certain applicants may pay an amount equal to the excess portion above the Medicaid level towards their medical care (like a deductible); thereafter, Medicaid pays for the rest of the applicants' medical bills. To be eligible for the "spenddown" program, applicants must fall into one of the following categories: under 21 years of age, 65 or older, blind, disabled, pregnant or the parent of child under 21.

    Medicaid Applications

    • New Yorkers may apply for Medicaid at their local office of social services. In New York City, applicants should contact the Office of Human Resources Administration. Pregnant women and children may apply at various clinics and hospitals throughout the state. Proof of income may encompass documentation including Social Security and Veteran's Benefits and Supplemental Security Income, as well as other sources. Applicants may direct an Access NY Health Care application to their local social services department.

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