You can apply for Medicaid through HRA if you:
If any of these categories describe your case, call the HRA Helpline at 1-888-692-6116 or visit any one of the Medical Assistance Program Offices.
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 1-855-355-5777.
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.
If you have any questions about Medicare or Medicare Part D, or about choosing a Part D prescription drug plan or changing the one in which you were enrolled by Medicare, read more information here.
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.
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.