New York Medicaid Frequently Asked Questions (FAQs)

Medicaid is a federal and state health insurance program that provides free or low-cost health coverage to eligible New York residents.

New York Medicaid may provide coverage for:

• Adults and families with low incomes
• Children and pregnant individuals
• Older adults
• Individuals with disabilities
• People who qualify for both Medicare and Medicaid

Eligibility depends on income, household circumstances, and other program requirements.

Learn more about New York State Medicaid.

New York residents may qualify for Medicaid based on their income, household size, age, disability status, and other eligibility requirements.

Income and resource limits vary depending on the Medicaid eligibility category. Some individuals may qualify under special eligibility rules.

New York Medicaid Income Guidelines

Medicaid income limits are updated periodically and may differ for children, adults, pregnant individuals, older adults, and people with disabilities.

For current income and resource requirements, visit the New York State Department of Health Medicaid Eligibility Guidelines.

You can also explore coverage options through NY State of Health.

New York Medicaid covers a wide range of medically necessary health care services. Depending on eligibility and coverage, benefits may include:

• Primary care and specialist visits
• Preventive care and immunizations
• Hospital and emergency services
• Prescription medications
• Laboratory tests and X-rays
• Dental care
• Vision care and eyeglasses
• Behavioral health and substance use disorder services
• Medical equipment and supplies
• Home health care and certain long-term care services
• Medically necessary transportation services

Specific benefits and coverage requirements may vary by Medicaid program and individual eligibility.

Visit the New York State Medicaid Benefits FAQs for additional information.

Medicaid generally provides health coverage without a monthly premium for eligible individuals.

Depending on the Medicaid program and services received, some individuals may have copayments or other cost-sharing requirements. Many services and eligible populations are exempt from copayments.

Learn more about Medicaid coverage and costs.

Yes. New York Medicaid provides coverage for eligible pregnant individuals, including prenatal care, labor and delivery, and postpartum services.

Medicaid also covers many preventive health services, including recommended screenings and reproductive health care.

Eligible individuals diagnosed with certain cancers may qualify for coverage through the New York State Medicaid Cancer Treatment Program.

Eligibility and covered services depend on individual circumstances and program requirements.

Yes. Individuals who qualify for both Medicare and Medicaid are known as dual-eligible individuals.

Medicare generally provides health coverage for people age 65 and older and certain younger individuals with qualifying disabilities or medical conditions.

Medicaid may help eligible individuals pay certain Medicare costs and provide additional covered services.

Learn more about Medicare and Medicaid dual eligibility in New York.

Medicaid coverage generally continues as long as you meet the program's eligibility requirements and complete any required renewal steps.

Many Medicaid members must periodically renew their coverage. Renewal requirements and coverage periods can vary based on individual circumstances.

Keep your contact information up to date and respond to renewal notices or requests for information by the stated deadline.

Learn more about changes to Medicaid coverage.

New York residents can apply for Medicaid through different enrollment channels depending on their eligibility category.

• NY State of Health: Visit NY State of Health to explore eligibility and apply for coverage.
• Enrollment Assistance: Free enrollment assistance is available through NY State of Health.
• Local Department of Social Services: Certain individuals, including many adults age 65 and older or those seeking specific long-term care services, may apply through their local social services office.
• Phone Assistance: Call NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220).

For additional application information, visit the New York State Medicaid Application Guide.

If you are enrolled in a Fidelis Care Medicaid Managed Care plan, you can use our online provider search tool to find participating doctors, specialists, hospitals, and other health care providers.

Visit Find a Doctor, select your health plan, and search by location or provider type.

Provider participation may vary by plan. Confirm network participation before scheduling an appointment.

If you no longer meet Medicaid eligibility requirements, you may qualify for other health insurance options through NY State of Health.

Depending on your income, age, and household circumstances, other coverage options may include the Essential Plan, Child Health Plus, or a Qualified Health Plan.

Visit NY State of Health to explore available coverage options and determine whether you qualify for financial assistance.