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Some services have small co-payments. These services may be provided using your Medicaid card or through your managed care plan if you are enrolled in managed care. You will not have a co-pay if you are in a managed care plan, except for pharmacy services, where a small co-pay will be applied. If you are eligible for Medicaid, you will receive a Benefit Identification Card which must be used when you need medical services.

There may be limitations on certain services. For you to use your Benefit Identification Card for certain medical supplies, equipment, or services e. Your year begins on April 1st and ends March 31st each year. You cannot be denied care or services because of your inability to pay a co-payment. A provider has the right to ask you for the co-payment at each visit and bill you for any unpaid co-payments.

A Medicaid Managed Care health plan will provide your care by working with a group network of doctors, clinics, hospitals and pharmacies. Your PCP will provide most of your care. You will need a referral from your PCP to see a specialist and for other services.

Managed care covers most of the benefits recipients will use, including all preventive and primary care, inpatient care, and eye care. People in managed care plans use their Medicaid benefit card to get those services that the plan does not cover. In many counties you can join a plan if there is one available and you want to.

However, there are some counties where families will have to join a plan. Please check with your local social services department to see if you have to join a plan. Health coverage providers are required to report certain health benefit information to the Internal Revenue Service IRS. This form does not require any action on your part. You may receive additional B forms from more than one provider if you changed coverage in the past year. For additional information about the B form you received, please click on the following link.

If you receive a letter from the IRS, please click on this link for additional information. If you think you are disabled, and if you meet the criteria for disability included in the Social Security Act, you may be eligible for Medicaid even if your income is otherwise too high.

If you believe you are disabled, you should furnish the local department of social services with medical evidence about your impairment s. The cost of such examinations, consultations, and tests requested by the disability review team, if not otherwise covered, will be paid by the local social services agency. NOTE: Persons who are denied for reasons of failure to meet the disability criteria are entitled to appeal the disability decision that led to the denial of their application.

See the section of this page entitled " "What are my rights? The following questions are only for people who are 65 years of age or older, certified blind, certified disabled, or in need of care in a nursing home.

These individuals have a resource test. Resources are cash or those assets, which can be readily converted to cash, such as bank accounts, life insurance policies, stocks, bonds, mutual fund shares and promissory notes.

Resources also include property not readily converted to cash i. Under Medicaid you are allowed to keep a small amount for your personal needs. You can also keep some of your income for your family if they are dependent on you. A spouse who remains in the community may also keep resources and income above the levels shown. When applying for Medicaid for nursing facility services Nursing Home , the local department of social services will look at financial transactions to determine whether any assets have been transferred or given away for less than fair market value during a certain time period prior to your application in order to determine if a transfer of assets penalty period needs to be applied.

This is known as the "lookback" period. Currently the "lookback" period is 60 months 5 yrs prior to the month you are applying for coverage of nursing home care. A penalty period may be imposed for the transfer of non-exempt assets for less than fair market value.

The penalty period results in a period of ineligibility for Medicaid coverage of nursing facility services. For more information regarding the transfer of assets and penalty periods, please contact your local department of social services. A life estate is limited interest in real property. A life estate holder does not have full title to the property, but has the use of the property for his or her lifetime, or for a specified period.

The life estate is not considered a countable resource, and no lien may be placed on it. If you or your spouse sell the life estate interest for less than fair market value, it can be considered a transfer of assets and may be subject to the penalty period. You may establish an irrevocable pre-need funeral agreement with a funeral firm, funeral director, undertaker or any other person, firm or corporation which can create such an agreement for your funeral and burial expenses.

Pre-need burial agreements purchased for certain members of your family on or after January 1, must also be irrevocable. The pre-need funeral agreement is used towards burial and funeral expenses and is not counted as a resource when determining Medicaid eligibility. Please note, these funds, must be kept separate from any non- burial fund related resources. Navigation menu. Questions How do I apply for Medicaid? You can apply for Medicaid in any one of the following ways: Write, phone, or go to your local department of social services.

Pregnant women and children can apply at many clinics, hospitals, and provider offices. Call your local department of social services to find out where you can apply. If you are in a facility operated by the New York State Office of Mental Health , contact the patient resource office. If you are in a facility certified by the New York State Office for People With Developmental Disabilities , contact the revenue and reimbursement office.

How to obtain Medicaid payment records. New Requirement for Medicaid Effective November If you are turning age 65 within the next three months or you are age 65 or older, you may be entitled to additional medical benefits through the Medicare program. If the Medicaid program can pay your premiums, you will be required to apply for Medicare as a condition of Medicaid eligibility.

If you go to your local SSA office, you should bring : Proof of date of birth e. You may be covered by Medicaid if: You have high medical bills. You meet certain financial requirements. Please read OHIP below for more information on who is required to apply for Medicare and how to apply. You can find this document here DOH If you think you have an immediate need for Personal Care Services PCS or Consumer Directed Personal Assistance Services CDPAS , you may have your eligibility for these services processed more quickly if you: have no voluntary informal caregivers able and willing to provide or continue to provide care; are not receiving needed assistance from a home care services agency; have no third party insurance or Medicare benefits available to pay for needed assistance; and have no adaptive or specialized equipment or supplies in use to meet, or that cannot meet, your need for assistance.

If you need help finding what you're looking for, please visit our Site Map, use the search above, or you can contact us directly for assistance. Effective September 27, , this option has re-opened for providers who hold a current professional license issued by a state other than New York and who would like to practice in New York during the current statewide disaster emergency.

The HHS application portal is scheduled to open on September 29, An original voided check or original signed and notarized letter from your bank is required.

The tax number entered on the form must match the tax number for the provider NPI on the form. Be sure to complete all fields. Only original signed forms will be processed. PDF remittances look like the paper remit but are delivered via the eXchange in-box. Complete the EFT Form. Visit the online public benefits screening and application tool. City Council, 51 Members. Public Advocate.

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