NY Medicaid | FAQs

Medicaid is a joint federal-state health care program for the disadvantaged. In New York, it offers free or low-cost medical treatment to:

• Adults with low income
• Low-income families and children
• Individuals with disabilities
• Certain senior citizens who use Medicare

There are other options to assist low-income people who are not Medicaid eligible. Learn more by contacting a Fidelis Care representative here.

Children and adults who meet income, resource, age, and/or disability requirements can apply for Medicaid.

To learn more about income requirements, contact the NYS Medicaid Helpline at 800- 541-2831. You can check online for eligibility by contacting a Fidelis Care representative here.

2025 Income Guidelines

Effective January 1, 2025. Income and Resource Levels are subject to yearly adjustments.

Source: https://www.health.ny.gov/health_care/medicaid/how_do_i_apply.htm

The NYS Medicaid program covers:

• All regular medical checkups andneeded follow-up care
• Immunizations
• Doctor and clinic visits
• Medications
• Medical supplies
• Medical equipment and appliances(wheelchairs, etc.)
• Lab tests and X-rays
• Eye care and eyeglasses
• Emergency care
• Dental care
• Nursing home care
• Emergency ambulance transportation toa hospital
• Hospital stays

Learn more about Medicaid coverage by contacting a Fidelis Care representative here.

There is no monthly premium for Medicaid.

Yes, if breast, cervical, or colorectal cancer is found, some people may be able to enroll in the New York State (NYS) Medicaid Cancer Treatment Program to receive full Medicaid coverage for the entire time they are being treated for cancer.

Prenatal care is available through expanded Medicaid coverage. For some pregnant women, services may be limited to perinatal care if their incomes are too high to qualify for full Medicaid coverage.

Yes, it is possible to be enrolled in both Medicaid and Medicare at the same time. This is called “dual eligible.” Medicare is a health insurance program for:

• Individuals ages 65 and older
• Individuals younger than age 65 who are disabled
• Individuals with end-stage kidney disease

When you use Medicare, you must pay monthly premiums as well as other expenses like copays and deductibles. If you have Medicare and a low income, you might be eligible for Medicaid assistance to cover your Medicare expenses. Learn more about dual eligibility here.

Medicaid benefits are continuous as long as you continue to meet the eligibility requirements. If your circumstances change and you no longer meet the eligibility requirements, Medicaid benefits may be discontinued. Learn more by contacting a Fidelis Care representative here.

You can apply for Medicaid in the following ways:

• Through NY State of Health: The Official Health Plan Marketplace
  • Enrollment Assistors offer free personalized help.
  • To speak with the NYS customer service professional, call 1-855-355-5777 (TTY: 1-800-662-1220)
• Through a Managed Care Organization (MCO)
• Call the Medicaid Helpline at 800-541-2831
• Through your Local Department of Social Services Office

Where you submit your application depends on your Medicaid eligibility category. Representatives will help you make sure you can apply in the appropriate area.

Finding a provider in Fidelis Care’s network is easy with the Find a Doctor online tool. Enter your preferred location, select Medicaid, and choose the type of care or service you want. A list of providers will appear.