You can apply for Medicaid in NYC online, by mail, by fax, or in person, and which door you use depends on your age and whether you have a disability. Most adults under 65, children, and pregnant women apply through the NY State of Health marketplace. People 65 or older, those with a disability or blindness, Medicare recipients, and former foster youth under 26 apply through the city’s Human Resources Administration (HRA). A single adult qualifies with income up to $22,025 a year, with higher limits for larger households, children, and pregnant applicants.
Figure Out Which Agency Handles Your Application
Sending your paperwork to the wrong place is the fastest way to lose weeks. New York splits Medicaid applications between two tracks.
The MAGI track, run through NY State of Health, covers adults under 65, children, and pregnant women. Eligibility is based on Modified Adjusted Gross Income compared against the Federal Poverty Level.1Medicaid.gov. Eligibility Policy
The non-MAGI track, run through HRA, covers people who are 65 or older, certified blind, disabled, on Medicare, or former foster youth under 26. This track looks at both income and countable resources like bank accounts and investments, using the income methodology from the Supplemental Security Income program. Your home, one vehicle, and certain other assets are typically excluded from the resource count.2Human Resources Administration. Health Assistance
Income Limits for 2026
The 2026 annual income ceilings for the main categories are:3NYC.gov. Medicaid Income Eligibility Levels
- Adults under 65 (138% FPL): $22,025 for one, $29,864 for two, $37,702 for three, $45,540 for four.
- Children ages 1–18 (154% FPL): $24,579 for one, $33,326 for two, $42,073 for three, $50,820 for four.
- Pregnant women and infants under 1 (223% FPL): $35,591 for one, $48,258 for two, $60,924 for three, $73,590 for four.
Each additional household member adds roughly $7,839 to $12,667 to the limit, depending on the category.3NYC.gov. Medicaid Income Eligibility Levels
Documents to Gather Before You Start
Missing paperwork is the most common reason applications stall. Only bring what applies to your situation.4New York State Department of Health. Documents Needed When You Apply for Health Insurance
- Identity: U.S. passport, state driver’s license or ID card with photo, or another government-issued photo ID. New York accepts a wide range of identity documents, including school IDs with photos and employment authorization cards.5New York State Department of Health. Identity Documentation Requirements for NYS Medicaid
- Residency: A utility bill, lease or landlord letter, rent receipt, or postmarked mail showing your NYC address, dated within six months of your application.
- Income: Pay stubs, a signed letter from your employer, your most recent tax return, or a Social Security benefit statement. Provide one proof for each type of income in your household.
- Immigration status (if not a U.S. citizen): Permanent Resident Card, Employment Authorization Card, refugee travel document, or other immigration papers.
- Household composition: Birth or marriage certificates if needed to verify family size.
Citizenship and Social Security numbers are verified through federal databases during the application. If the automated check doesn’t match, you’ll be asked to submit documentation afterward.6New York State Department of Health. How to Apply for NY Medicaid
The Four Ways to Apply
Online Through NY State of Health
Most adults under 65, children, and pregnant women apply at nystateofhealth.ny.gov. The portal walks you through personal details, household income, and health information. You can attest to your expected income for the coming year, though you may need to send documentation later if the system can’t verify your numbers electronically. For phone assistance or to start an application by phone, call the Marketplace Customer Service Center at (855) 355-5777.6New York State Department of Health. How to Apply for NY Medicaid
Online Through Access HRA
If you’re 65 or older, disabled or blind, on Medicare, or a former foster youth under 26, apply through Access HRA at a069-access.nyc.gov/accesshra. The free website and app let you submit your application and upload supporting documents.2Human Resources Administration. Health Assistance
Paper Application by Mail or Fax
The Access NY Health Care Application (form DOH-4220) can be downloaded from the NY State of Health website or picked up at an HRA Medicaid office. Completed forms can be mailed or faxed to HRA. Mailing addresses and fax numbers change, so call the HRA Medicaid Helpline at 1-888-692-6116 to confirm the current address before sending anything.2Human Resources Administration. Health Assistance Use certified mail with return receipt and keep a copy of everything you send.
In Person at an HRA Office
You can walk into an HRA Medicaid office in any borough and apply with a caseworker. Worth the trip if your situation is complicated or you have questions about documents. You can also designate someone to handle the application for you by completing form DOH-5085.6New York State Department of Health. How to Apply for NY Medicaid
What Happens After You Submit
Federal rules give the state 45 calendar days to decide a standard application, and 90 days for one based on a disability because a medical determination is required.7eCFR. 42 CFR 435.912 – Timely Determination and Redetermination of Eligibility HRA may contact you for more documents during that window. Answer quickly. Delays on your end can push the timeline past these deadlines.
You’ll receive the decision by mail. If approved, you’ll get a Common Benefit Identification Card (CBIC) in the mail, which serves as your Medicaid ID at providers.8Human Resources Administration. Electronic Benefit Transfer Cards For an immediate medical need, the local office can issue a temporary paper authorization while your permanent card is in transit.9New York State Department of Health. Medicaid Reference Guide – Card Issuance
Most people approved for Medicaid in NYC are required to enroll in a managed care plan to receive benefits.10New York State Department of Health. Overview of Medicaid Managed Care Pick your plan promptly. If you don’t, one is assigned to you, and the assigned plan may not include your preferred doctor or hospital.
Bills From the Last Three Months
Medicaid can pay for medical bills you incurred during the three months before the month you applied. The retroactive period starts on the first day of the third month before your application date. Apply on April 30 and Medicaid can cover bills from January 1 through March 31, as long as you were eligible during that time.11New York State Department of Health. Medicaid Reference Guide – Retroactive Eligibility Period
This works whether you still owe the money or already paid it out of pocket. Indicate on your application that you have unpaid or paid medical expenses from the prior three months, and the agency has to evaluate your eligibility for that retroactive period. Hold onto bills and receipts.
If Your Application Is Denied
You have 60 days from the determination to request a state fair hearing, which is an independent review of the agency’s decision.12New York Codes, Rules and Regulations. 18 NYCRR 358-3.5 – Requests for a Fair Hearing Request one by calling 1-800-342-3334, submitting a request online through the Office of Temporary and Disability Assistance website, or mailing a written request.
Common denial reasons include missing documents, income reported above the threshold, or failure to respond to a request for information. Before requesting a hearing, check whether the denial was based on something fixable, like a missing pay stub. Resubmitting the correct documents often resolves the issue faster than a hearing.
Keeping Coverage After You’re Approved
Medicaid is not permanent. Most enrollees renew once a year. The agency first tries to verify continued eligibility electronically using data sources like tax records. If that works, your coverage is renewed automatically. If not, you’ll get a renewal packet in the mail. Fill it out and return it promptly. People lose coverage every year simply because they didn’t open the envelope in time, not because they were ineligible.
Starting January 1, 2027, a new federal requirement takes effect that shortens the renewal cycle to every six months for most adults enrolled through the Medicaid expansion group.13Medicaid.gov. Implementation of Eligibility Redeterminations – SMD 26-001 Keep your contact information current with HRA so renewal notices reach you.
A Warning for Applicants 55 and Older
Under New York Social Services Law Section 369, the state can seek repayment of certain Medicaid costs from your estate after you die, including nursing home care, home and community-based services, and related hospital and prescription drug costs provided on or after age 55.14New York State Department of Health. Important Information Regarding Medicaid Estate Recovery The state’s definition of “estate” is broad and includes property held in joint tenancy, living trusts, and life estates, though recovery is deferred while a surviving spouse, a child under 21, or a certified blind or disabled child is living.
Separately, if you give away or sell assets below market value within 60 months before applying for Medicaid nursing home coverage, you’ll face a penalty period during which Medicaid won’t pay for your care. In New York City, the 2026 divisor used to calculate that penalty is $15,282 per month.15New York State Department of Health. GIS 25 MA/14 – 2026 Regional Nursing Home Rates Transferring $100,000 of assets in NYC would result in roughly a 6.5-month penalty during which you would pay your own nursing home costs. If you’re over 55 and considering Medicaid, talk to an elder law attorney before applying.
Free Help and Key Phone Numbers
Certified enrollment assistors (sometimes called Navigators) can walk you through the entire process at no charge, and you can search for one through the NY State of Health website.6New York State Department of Health. How to Apply for NY Medicaid Community-based organizations across the city also provide free in-person help in multiple languages.
- NY State of Health Customer Service: (855) 355-5777, TTY 1-800-662-1220
- HRA Infoline: (718) 557-1399
- HRA Medicaid Helpline: 1-888-692-6116
- Fair Hearing Requests: 1-800-342-3334