HRA's Medical Assistance Program can help New Yorkers who qualify enroll in public health insurance programs like Medicaid. HRA accepts applications from residents who are age 65 or over, persons of any age who are living with a disability or blindness, persons who are in receipt of Medicare and are not a parent or caretaker relative of minor children, and former foster young adults under age 26. Call the HRA Medicaid Helpline at 1-888-692-6116 for more information or visit a Medicaid Office to apply. During the COVID-19 Emergency, applications may be submitted via fax to 917-639-0732.
Medicaid clients who have lost their EBT cards and have a change of address, should contact the Medicaid helpline to update their contact information at 888-692-6116 to update their address. Clients can also use the MAP-751K form below to make this change and fax it to 917-639-0837.
Consumer/Provider Request to CHange Informaiton on File (MAP-751k)
Medicaid clients who have case changes that require additional documentation should use the MAP-751W form below. The documentation should also be submitted with the MAP-751W.
Consumer/Provider Request to CHange Informaiton on File (MAP-751W)
Request an application for Medicaid Housekeeping Services or ask home care questions by calling the CASA Office in your borough.
Other consumers must apply to the NY State of Health at nystateofhealth.ny.gov or by calling 855-355-5777.
HRA's Office of Citywide Health Insurance Access also has resources for individuals and small businesses who want to learn more about public and private health insurance, including the Affordable Care Act.
You can also find fact sheets and brochures to better understand your health insurance and coverage options under ACA. Learn how you can get covered.
Clients may attest to all elements of eligibility except Immigration Status and Identity, if immigration document does not also prove identity. Copies of documents that prove immigration/identity status should still be submitted. Do not submit original documents. If clients are unable to submit this documentation due to the COVID-19 Emergency, the application should still be submitted. Clients will be given an opportunity to submit the documents later. Clients whose citizenship status is not verified through data sources will also be given an opportunity to submit the documents later.
Clients do not need to provide proof of their Medicare application; this requirement is waived for the period of the COVID-19 emergency.
Call the HRA Medicaid Helpline at 888-692-6116 for more information. During the COVID-19 Emergency, applications may be submitted via fax to 917-639-0732.
During the COVID-19 emergency, Medicaid cases with authorization ending in March 2020 through December 2020 and January 2021 through December 2022 will be automatically extended. Any case that is closed for failure to renew or failure to provide documentation during COVID-19 will be re-opened and coverage restored to ensure no gap in coverage. Excess resources cases will be extended for 6 months. Surplus cases will be extended 6 months. See below for information regarding coverage for Surplus cases.
During the week of May 18-23, 2020, Medicaid/ Managed Long Term Care/ Nursing Homes/ Medicare Savings Program Renewal (Recertification) Notices of Intent to close Medicaid cases were sent in error to clients whose renewals were due in May 2020. The Medicaid cases will not close for any of these consumers and coverage will be extended, whether or not the client returned the renewal, as per New York State COVID-19 emergency easements.
The renewal extension applies to all renewal cases including Office of Mail Renewal, MLTC, Nursing Home Eligibility, Medicare Savings Program, MBI-WPD (entitled to 6 months extended grace period if loss of employment), Stenson/Recipients who lose their SSI eligibility and Rosenberg/Recipients who lose their eligibility for cash assistance.
These guides help you fill out your Medicaid Renewal and give examples of documents you can use to give proof of information we need to decide on help for you. These guides don't mention every type of document. Other documents may be used, even if not on the list.
Instructions to Complete the Disabled, Aged, and Blind (DAB) Renewel Notification Form (MAP-2096P)
Guide to Complete Your Medicaid Renewel Forms
These forms may be needed for legally responsible relatives or to declare or change an authorized representative
Medicaid Authorized Representative Designation/Change Request (DOH-5247)
Applicant/Recipient Declaration Concerning LLR Income-Resources (MAP-2161)
If you are unable to submit payment because of health issues related to COVID-19, such as quarantine or hospitalization, you can attest that you either have the money or the bills to satisfy your surplus and are unable to submit them due to COVID-19 by calling the Surplus Hotline at 929-221-0835.
Use the MAP-3177 form below if you need a disability determination to participate in the Medicaid Buy-in Program for Working People with Disabilities (MBI-WPD) or if you are an individual aged 65 or older who is participating in a pooled trust.
Disability Determination Request (MAP-3177)
The Medicaid Buy-In program offers coverage to people with disabilities who are working and earning more than what is allowed in traditional Medicaid.
To qualify you must meet all the following requirements:
If you meet these requirements and receive Medicaid coverage with a monthly spenddown, you can still enroll in the MBI–WPD program. Participants in the MBI-WPD program don't have to pay a spenddown. You should continue to pay your spenddown until your MBI- WPD application is approved.
If you have health insurance coverage through your employer, you should keep that insurance and reach out to HRA. Medicaid may cover the cost of the premium for that insurance coverage.
The MBI-WPD program does not offer family coverage. Single people and married couples are both covered under this program if both individuals are working and have a disability. Spouses without a disability and children may be covered through other programs such as Medicaid through New York State of Health or Child Health Plus.
You or your authorized representative can apply by mailing in an application to the address below:
Initial Eligibility Unit
HRA/Medical Assistance Program
PO Box 24390 Brooklyn, NY 11202-9814
You can also fax your application to 917-639-0732. Your authorized representative can fax an application to 917-639-0731.
You or your authorized representative can also apply at any local Medicaid office within New York City. You can call 311 for the nearest Medicaid Office, or visit our Medicaid Office page for the complete list.
For more information, call the Medicaid Helpline at 1-888-692-6116 or visit the NYS website.