Medical Assistance Program

Medicaid Coverage - Hurricane Sandy

The HRA Medical Assistance Program (MAP) is responsible for the administration of New York State's free and low-cost public health insurance programs for low-income, eligible New York City residents.  These plans provide coverage for medical care through fee-for-service arrangements with participating medical providers or through managed care plans.  MAP determines and maintains eligibility for applying and renewing consumers based upon criteria including income and/or resource levels for each of the available health insurance programs and their related services.  Applications are available in English and Spanish.

Most low-income families and individuals who cannot afford to pay for their medical care including pregnant women, children, persons receiving cash assistance or Social Security Income (SSI), persons who are 65 and over, the disabled and the blind, are eligible for Medicaid.  Individuals and families can qualify for public health insurance even if they have income, own a house, own a car, have a bank account or have a private health insurance policy.  It is required that recipients of public health insurance recertify their eligibility as required by law.

Currently, the main public health insurance programs available in New York City are:

  • Medicaid (MA) - provides free health insurance coverage to adults ages 19 and over through managed care or through fee-for-service providers.
  • Family Health Plus (FHP) - provides free health insurance coverage to adults ages 19 through 64 who do not have health insurance, either on their own or through their employers. Medical services are received from managed care providers.
  • Child Health Plus (CHP) - provides free or low cost health insurance to children under age 19, living in NYC. Most children receive their medical services through a health plan.
  • Medicare Savings Program (MSP) - pays Medicare premium, deductible and co-insurance costs.
  • Excess Income/Resource (also known as the Surplus or Buy-In Program) - allows applicants with income or resources in excess of the Medicaid levels to become eligible for Medicaid once they incur medical bills that equal or exceed the difference.
  • Medicaid Buy-in Program for Working People with Disabilities (MBI-WPD) - provides Medicaid coverage to disabled working persons who would otherwise be financially ineligible for Medicaid.
  • Family Planning Benefits Program - provides free family planning services for individuals through fee for service providers.

For more information on the programs and their eligibility requirements, please see Your Guide to Public Health Insurance & Eligibility (PDF).

Learn more about alternatives to public health insurance.

Services Covered by Medicaid
The following services may be paid for by Medicaid if all eligibility conditions are met. Some services have small co-payments. These services may be provided using your Medicaid card or through your managed care plan. You will not have a co-pay for most services if you are in a managed care plan.

  • smoking cessation agents
  • treatment and preventive health and dental care (doctors and dentists)
  • hospital inpatient and outpatient services
  • laboratory and X-ray services
  • care in a nursing home
  • care through home health agencies and personal care
  • treatment in psychiatric hospitals (for persons under 21 or those 65 and older), mental health facilities, and facilities for the mentally retarded or the developmentally disabled
  • family planning services
  • early periodic screening, diagnosis, and treatment for children under 21 years of age under the Child/Teen Health Program
  • medicine, supplies, medical equipment, and appliances (wheelchairs, etc.)
  • clinic services
  • transportation to medical appointments, including public transportation and car mileage
  • emergency ambulance transportation to a hospital
  • prenatal care
  • some insurance and Medicare premiums
  • other health services

Learn more about these programs and services.

Medical Transportation Division
New York City Medicaid recipients have access to medically necessary and appropriate transportation services to and from medical treatment based on their functional limitations. The medical treatment must be a Medicaid covered service. For more information, please  read the Medical Transportation Services (PDF).

Public Transportation Automated Reimbursement System (PTAR) 
MICSA can also receive electronic submissions of public transportation reimbursement claims. If you are already an authorized facility for public transportation reimbursement claims or interested to read the overview, click on the quick link (to the right).

Privacy
The Medical information Privacy Notice (PDF) details how medical information regarding you and/or your dependents may be disclosed.

MAP can also receive electronic submissions of public health insurance applications from certain types of organizations.  If you are already, or would like to become an electronic submitter view the HRA Eligibility Data and Image Transfer System (EDITS).

Learn about MAP Eligibility, Application & Renewal.


HRA Services

How Do I...
Quick Links

Programs/Services:
MICSA
Medicaid
MAP Eligibility
EDITS
Public Transportation Automated Reimbursement System (PTAR)

Brochures & Reports:


Other Information: