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Medicaid Rules in New York

To apply for Medicaid in the state of New York, residents must contact their local department of social services in person, by phone or by mail and complete an application for Medicaid. New York City residents should contact the Human Resources Administration. Applicants must have proof of age, proof of citizenship, proof of income, proof of residence, such as a rent receipt, and an insurance card if the applicant has any other type of medical insurance.

  1. What is Income?

    • New York residents must report all income on the Medicaid application. Income includes salary, wage, any contractual income, tips, bonuses, self-employment income and any income received from renters or roommates. Income also refers to any unearned income such as retirement funds, social security, food stamp value, cash assistance, disability payments, interest, dividends and income from a reverse mortgage.

    Eligible Persons

    • People under the age of 21, those that have dependents under the age of 21 and pregnant women are eligible for Medicaid, if income requirements are met. Eligible persons under the age of 21 who may be eligible include full-time student or part-time student under the age of 21 and employed part-time. Also disabled persons and those persons over the age of 65 are eligible for assistance under expanded income guidelines.

    Federal Poverty Level Guidelines

    • If all income exceeds 100% of the current federal poverty level, the applicant is not eligible for Medicaid in New York. If income is below 100% of the federal poverty level, the applicant is eligible. For example, a family of three must have income not exceeding $1,050 per month (as of 2010). Disabled applicants and applicants at least 65 years of age may earn more. For instance, a family of three that includes a disabled or elderly person may earn $1,285.

    Exceptions to Federal Poverty Guidelines

    • Those that are medically needy may be eligible for Medicaid under expanded income requirements. Applicants that are pregnant may be eligible if they meet either 100% or 200% of the federal poverty level. Those applicants that are under the age of one year old must have a family income that is 200% of the poverty level, children under age one up to age five must have a family income meeting 133% of the poverty level, and those age six to eighteen must have a family income of 133% of the federal poverty level. For example, a family of three with a child that is two years old may earn up to $2,030 per month.

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