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Financial Eligibility
MAP-909E HRA DAB Renewal Form Redacted (2023-12-06) Download
MAP-909e DAB Renewal (2023-12-06) Sample with 2023 ACT NOW insert_Redacted.pdf
HRA Medicaid Renewal Form for Disabled, Aged, & Blind (DAB) recipients - 12/6/2023 version
(1) a 2-page Renewal Notification letter with the deadline to return the renewal, which is always the 10th of the 2nd month after the notification,
(2) "STOP ACT NOW" alert intended to alert consumers that this renewal MUST be returned, unlike those sent during the Public Health Emergency (MAP-3185 - 2025-01-09),
(3) Renewal form has a new section in Part 6 RESOURCES requiring authorization for HRA to verify resources using data matching - must be signeded by recipient and spouse(page 7, 12-13 of the PDF);
(4) Renewal form must be signed by both applicant and spouse (p. 15 of PDF)
(5) Financial Maintenance form - not new - only required if housing costs are more than 70% gross monthly income (p. 10 of PDF);
(6) Renewal instructions (pp. 15-17 of PDF)
(7) Bar coded return envelope - LAST PAGE of PDF. If you don't have this, mail it to the address on this copy CERTIFIED.
13 May, 2025 2.89 mb Downloads: 17132
Currency Conversion Worksheet for Holocaust Reparations Download
Reparation worksheet.xls (4-2025).xlsx
Use this worksheet to convert lifetime total amount received in Holocaust reparations / restitution from foreign currencies (Deutschmarks and Euros) into U.S. Dollars. This is for purposes of taking advantage of the exemption of saved reparations payments from the resource test for Federally-funded means-tested benefits, like Medicaid and Supplemental Security Income. Updated monthly.
01 May, 2025 148 kb Downloads: 9218
HRA Medicaid Alert 3/19/2025 - NYS Disability Determination Requirements Download
2025-03-19 State Disability Determination Requirements.pdf
This alert reiterates the previous Alert dated April 18, 2024 and one earlier in 2022. When requesting a Disability Determination, submit only MAP-3177 Disability Determination request. HRA will forward this to the NYS Disability REview Unit, which will then request the rest of the documents listed in this article - http://health.wnylc.com/health/entry/134/.
16 Apr, 2025 123 kb Downloads: 122
NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2024 Download
2001_to_2024_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001 - 2024. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
07 Mar, 2025 3.77 mb Downloads: 302497
Basic Eligibility for Medicaid and Home Care in NYS - Age 65+, Disabled, Blind Download
Medicaid Basic - 2025 final.pdf
This is basic information about Medicaid eligibility for the Disabled, Aged 65+, and Blind (DAB) category and about applying for Community Medicaid in order to receive home care (personal care or consumer-directed personal assistance) through Managed Long Term Care or based on Immediate Need through the local Medicaid program. (updated March 5, 2025 with final 2025 Income and Asset limits released by DOH)
07 Mar, 2025 279 kb Downloads: 196005
Excel Template for Medicaid Non-MAGI Budgeting -2025 FPL: Download
Medicaid Budgeting worksheet 2025.xls
Excel template to calculate Medicaid non-MAGI eligibility under the increased 2025 levels - see http://health.wnylc.com/health/news/90/. Can be used as a tool to estimate spend-down and pooled trust contributions. Template has different tabs for different types of budgeting schemes. -- See list of these at http://health.wnylc.com/health/entry/222/.
07 Mar, 2025 131 kb Downloads: 7999
Medicaid income and resource levels - 2025 (2-14-2025) Download
MAPDR-01 Feb 26 2025.pdf
NYC HRA MAPDR-01 (updated 02-14-2025) -- Although this was issued in Feb. 2025, almost all the figures are in yellow which means that they are still the 2024 figures. The 2025 figures can only be calculated after NYS Dept. of Health issues the 2025 Federal Poverty Levels (FPL) later in February or March (even though the FPLs were announced by the federal govt).
26 Feb, 2025 2.13 mb Downloads: 452435
NYLAG Memo in Support of Repeal of the 30-Month Lookback for Medicaid Home Care (S4786-A1907) Download
A1907 - S04786 Lookback repeal Memo in Support NYLAG 2025.pdf
NYLAG's statement in support of a bill S4786-A1907 to repeal the MRT-II cut enacted in 2020 that would impose a 30-month lookback and transfer penalty for eligibility for Medicaid home care and other community-based services.
25 Feb, 2025 207 kb Downloads: 936
HRA-MAP 931Y E-Fax Medical Bills Cover Sheet (2018) Download
MAP-931Y_E-Fax_Medical_Bills 2018-4-27.pdf
HRA Medicaid Fax Cover Sheet to Fax medical bills to meet spend-down (2018)
29 Jan, 2025 80 kb Downloads: 25759
NYLAG Comments on Proposal to Expand the Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) Download
MBI-WPD Public Comments by NYLAG - 12.5.24 - FINAL.pdf
Comments submitted by NYLAG with recommendations and support for New York's request to the federal Medicaid agency CMS to approve a waiver that would expand the MBI-WPD program to include people age 65 and over with higher income and resource limits.
19 Dec, 2024 333 kb Downloads: 291
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