If any of these categories describe your case, call the HRA Helpline at 888-692-6116 or visit any one of the Medicaid Offices. You can also apply online at ACCESS HRA.
Low-income pregnant women, children, and adults under 65 must apply for coverage through NY State of Health. It is operated by New York State and is the Official Health Plan Marketplace. Contact the Marketplace at 855-355-5777.
If you are a Medicaid consumer enrolled in the Surplus Income Program and will be having a non-legally responsible third party pay-in your surplus on your behalf, before they make the first payment they need to complete and submit this form.
To submit paid or unpaid medical bills to meet your surplus amount by FAX, please use this form: the MAP- 931Y Surplus Fax Medical Bills Cover Sheet. And FAX all requested information to the Medical Assistance Program Centralized Surplus Unit.
MAP-931y Surplus Fax Medical Bills
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 888-692-6116 or visit the NYS website.
Please be advised that these courses are intended for professionals or staff who assist consumers with Medicaid. These presentations cover all aspects of the Medicaid eligibility process which include the application and the renewal processes. You must be a registrant in the Medical Assistance Program Automated Resource Center (MARC) to register for these presentations, as the announcements for upcoming presentations are sent to all MARC registrants. MARC is intended for professionals and staff who assist consumers with the Medicaid process. Register for MARC. Please note you must register with your work/professional email and respond to a few questions about your agency and the population you serve. Once that is done the MARC administrator reviews your request and informs you when authorization is approved.
You do not need an attorney to complete this form; however, if you have any questions about creating a Power of Attorney or you need assistance in understanding the Power of Attorney, please seek assistance from legal counsel.
Please be advised that Powers of Attorney executed after September 1, 2009 must contain the language in the above link in order to be accepted by HRA. Powers of Attorney executed before September 1, 2009 which do not contain the above language may still be valid.