Medicaid is a federal and state program that pays for a comprehensive range of medical services for persons with low-income and limited resources. Medicaid should not be confused with Medicare. Medicaid is not an entitlement and requires an application process. The individual must meet income, resource and other requirements to be eligible. Medicaid is the primary source of funding for long term care in most states.
In New York State, Medicaid pays for the following services:
- Inpatient, outpatient and emergency hospital services
- Diagnostic and preventive services
- Prescription drugs, prosthetic devices and hearing aids
- Dental services and dentures
- Optometrist services and eyeglasses
- Physical therapy and rehabilitative services
- Speech, hearing and occupational services
- Skilled nursing facilities, private duty nursing, personal care services
- Case management, psychiatric, and hospice care
- Durable medical equipment and transportation
Who is eligible for Medicaid benefits?
- Supplemental Security Income recipients are automatically eligible. A separate Medicaid application is not necessary.
- Public Assistance recipients, although no longer automatically eligible. The Job Center must be notified that the individual is also applying for Medicaid. The Job Center will process both applications.
- People 65 or older, or who are certified disabled or blind and meet the monthly income requirements.
- Low income families (LIF).
- Children under the age of 21 who live in a family with deprivation of support, that is, the absence or incapacity of a parent, the unemployment or underemployment of a parent, or a pregnant woman with no other children and who is ineligible under the “LIF” category.
- ADC-U: Related Medically Needy. This is an intact family (both parents) with children under age 21, regardless of how many hours the principal wage earner worked.
- S/CC: Single/Childless Couples. A non-federal category which includes single or married adults between the ages of 21-64 who are not blind, not disabled, not pregnant, with no children under the age of 21.
Frequently Asked Questions about Medicaid
Are there citizenship requirements? Yes. The applicant must be:
- U.S. citizen
- Qualified alien (person granted Legal Permanent Resident Status and generally entitled to remain in the U.S. indefinitely)
- Non-citizen who has been granted political asylum or refugee status, or whose deportation has been withheld under the U.S. Immigration and Nationality Act
- Qualified alien serving in the U.S. military, or an honorably discharged veteran, their spouse, widow, and dependent children
- Qualified alien not listed above legally residing in the U.S. under statutory authority, considered to be Permanently Residing under the Color of Law (PRUCOL)
Where can I apply for Medicaid benefits?
- Contact the Human Resource Administration at 1- 877-472-8411 for the location of your nearest Medicaid
What documentation is required for the interview?
- Proof of age, such as a birth certificate, baptismal certificate for each person applying
- Proof of citizenship or lawful entry into the U.S.
- Social Security number for each person applying
- Proof of residence, such as utility bill
- If applicants are married, a marriage certificate
- If employed, current pay stubs for each person applying
- If the applicant is supported by someone else, the names of people who help support the applicant and the amount, cash or in-kind support that the applicant receives. `In-kind income' is a Medicaid term which refers to money paid directly to the Medicaid applicant's creditor (a landlord, for example) on behalf of the applicant, instead of giving this money directly to the applicant or putting it in the applicant's bank account.
- Bank books/savings account statements for the past 36 months
- Burial fund records, stock certificates and bonds
- Proof of recent rent/mortgage and utility expenses
- Tax bill or assessment notice if applicant owns real estate