Eligibility, Application & Renewal

Eligibility for public health insurance programs varies based on age, income, resources and/or medical requirements. 

Find out if you qualify for Medicaid, Family Health Plus or Child Health Plus

For income and resource eligibility information for all public health insurance programs, please see the table below:

Income and Resource Eligibility Levels for Public Health Insurance 
Public Health Program 
1Child Health Plus, Medicaid Monthly Income Levels (Pregnant Women and Children Under 21)Income_level.pdf
2Child Health Plus B Premium Levels - Monthly Income by Family Size (Children Under 19 Not Medicaid-Eligible)Income_level.pdf
3Family Health Plus Income LevelsIncome_level.pdf
4Family Planning Benefit Program Income Levels (Men and Women of childbearing age)Income_level.pdf
5Medicaid Buy-In for Working People with Disabilities Program Income LevelsIncome_level.pdf
6Regular Medicaid LevelsIncome_level.pdf
7Monthly Standard (Non-Disabled Adults ages 21-64 Without Children under 21 in Household) (a) Monthly Income Levels (b) Resource LevelsIncome_level.pdf
8Medicare Savings Program (Buy-In)Income_level.pdf
9Other Important FiguresIncome_level.pdf
10Spousal Support and Resource LevelIncome_level.pdf
11Monthly Regional Nursing Homes RatesIncome_level.pdf

If you have any questions about Medicare Part D or about choosing a Part D prescription drug plan or changing the one in which you were enrolled by Medicare, please call 311.

Learn more about alternatives to public health insurance or call 311.

Application Process
To find out if you are eligible for public health insurance such as Medicaid or Family Health Plus, you may apply in person at any Medical Assistance Program Community office. You may also send your application to us through a Facilitated Enroller (a community-based enrollment counselor) or by mail. If you want to apply for Medicare Savings Program coverage only, you have the option of applying in-person or by mail.

Individuals and families can submit applications and receive application assistance at any Medical Assistance Program Community Office. If you are unable to apply in person, a relative, friend or any person familiar with your situation may appear for you.  If you are unable to apply in person and have no representative, you may request application assistance at your home. 

For an application packet or additional information, call the HRA Medicaid Helpline at 1-888-692-6116 or visit any one of the Medical Assistance Program Community offices.

When applying for Medicaid, you will need to submit required documentation to prove eligibility.  Examples of accepted documentation include:

  • Proof of age, like a birth certificate
  • Proof of citizenship or alien status*
  • Recent paycheck stubs (if you are working)
  • Proof of your income from sources like Social Security, Supplemental Security Income (SSI), Veteran's Benefits (VA), retirement, or pension
  • Any bank books and insurance policies that you may have
  • Proof of where you live, like a rent receipt or landlord statement
  • Insurance benefit card or the policy (if you have any other health insurance)
  • Medicare Benefit Card

*NOTE: If you are pregnant or require treatment for an emergency medical condition, Medicaid coverage is available regardless of alien status. A doctor must certify that you are pregnant or had an emergency, and you must meet all other eligibility requirements.

Renewal Process
Annual renewal/recertification of health insurance coverage is required for all public health insurance programs. HRA has established a mail-in renewal system to ensure that individuals maintain their coverage. Children enrolled in Child Health Plus will receive a renewal package from their health plan 90 days prior to coverage expiration date. Children enrolled in Medicaid or Family Health Plus will receive a renewal package from HRA 90 days prior to coverage expiration date. An in-person interview is no longer required for renewal of coverage. You only have to complete and return the renewal forms, which contain a pre-printed form with the insured's household information.  

View instructions regarding renewing your coverage.

In order to maintain coverage, you must do the following: 

  • Review renewal/recertification carefully and make any necessary changes;
  • Check the "No Change" box if there are no changes to report;
  • Sign both the Renewal/Recertification Notice and the Terms, Rights, and Responsibilities document;
  • Supply proof of income, even if the income remains the same;
  • Return forms and all appropriate documentation by the "Respond By" date printed in the introductory paragraph.

If you need assistance completing mail-in renewal materials, contact information for health insurance enrollment counselors and the HRA Medicaid Helpline are included in the renewal package. Enrollment counselors can help the insured complete and send in renewal/recertification materials by due date. You can also receive assistance by contacting the HRA Medicaid Helpline through 311. Through the Helpline, you can obtain answers to questions regarding the renewal process in five languages: English, Haitian-Creole, Chinese, Russian and Spanish. Counselors are available Monday-Friday, 8AM-5PM to assist callers. A duplicate renewal/recertification package can also be requested through the Helpline.

You can drop-off renewal materials and seek help with completing renewal material at the HRA Medicaid Renewal Reception Site:

Manhattan: 340A West 34th Street, between 8th and 9th Avenues, 1st floor

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

As HRA moves ahead with implementing the PTAR system, we are requiring all existing and new providers participating in the MICSA Facility Reimbursement Program begin utilizing one of the aforementioned options of PTAR to submit Medicaid public transportation reimbursement claims, no later than January 1, 2010.  If your facility is interested in participating in PTAR, please contact Virginia Chung of the NYCHRA MICSA Medicaid Transportation Division via email, chungv@hra.nyc.gov or call (212) 630-1513.

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


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