NY Medicaid in New York

NY Medicaid is New York's Medicaid program — free or low-cost health coverage for low-income residents. It is administered by the New York State Department of Health.

Who qualifies for NY Medicaid?

New York covers adults 19–64 with income up to 138% of the Federal Poverty Level (FPL). Key qualifying groups include:

• Adults (19–64): Income up to 138% FPL (~$21,597/year single; ~$44,367/year family of 4)
• Children: Generally covered at higher income levels
• Pregnant women: Higher income limits apply
• Seniors and people with disabilities: SSI recipients qualify automatically

New York also offers the Essential Plan — near-zero premium health coverage for individuals earning 138–250% FPL who are not eligible for Medicaid. NYC residents can apply through the HRA Benefits Access Center or at a community-based organization. Child Health Plus covers children at higher income levels.

How to apply for NY Medicaid

You can apply through New York's official portal, by phone, by mail, or in person at your local New York State Department of Health office.

• Online: Apply at NY State of Health →
• Processing time: Most applications are processed within 45 days (90 days for disability-based applications)
• Coverage start: If approved, coverage typically begins the first day of the month you applied
• Renewal: Medicaid eligibility is reviewed annually — respond to renewal notices to avoid losing coverage

What does NY Medicaid cover?

Medicaid in New York covers a comprehensive set of services, including:

• Doctor visits and preventive care
• Hospital stays (inpatient and outpatient)
• Emergency services
• Mental health and substance use treatment
• Prescription drugs
• Lab tests and X-rays
• Prenatal care and delivery
• Long-term care (nursing home and home-based services)

Most services are covered at no cost or very low cost. Some plans may charge small copays for non-emergency services.

What documents do I need?

• Proof of identity (driver's license, state ID, or passport)
• Proof of New York residency (utility bill, lease, or bank statement)
• Proof of income (pay stubs, tax returns, or employer letter)
• Social Security numbers for all household members applying
• Proof of citizenship or immigration status

Common questions about NY Medicaid

Can I keep my doctor on NY Medicaid?

NY Medicaid is often provided through managed care plans. When you enroll, you will choose a plan and a primary care provider. If your current doctor accepts NY Medicaid, you can stay with them. Call your doctor's office to confirm before enrolling in a plan.

What if my income changes?

Report income changes to New York State Department of Health within 10–30 days. If your income rises above the limit, you may qualify for marketplace coverage with subsidies instead — coverage is typically available without a gap.

Can I have both Medicaid and private insurance?

Yes. If you have employer coverage, NY Medicaid can act as secondary insurance, covering costs your primary insurance doesn't pay. This is called "dual coverage" and can significantly reduce your out-of-pocket costs.