NY Health Access About Us   |   Contact Us Empire Justice Center Legal Aid Society NYLAG WNYLC
Financial Eligibility
HCSP 3026 ALP Medicaid Cover Sheet Download
HCSP-3026 HCSP Cover Sheet for ALP-MLTC 1-26-2015.pdf
This is the cover sheet for HRA-ALP Medicaid Cover Sheet
13 Apr, 2015 44 kb Downloads: 3753
Spousal Refusal Form - Suffolk County Download
Spousal Refusal Form - suffolk county.doc
This is the spousal refusal form for Suffolk County residents
13 Apr, 2015 25 kb Downloads: 14342
15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical & Medical Facilities Download
15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical and Medical Facilities.pdf
This informational letter provides social services districts with updated charts that represent the monthly Personal Needs Allowance, PNAs, for residents of non-medical facilities the PNAs in medical facilities.
13 Apr, 2015 302 kb Downloads: 3311
Agreement to Participate in the Medicaid Pay-In Program Download
MAP-931B Agreement to Participate in Pay-In Program searchable pdf.pdf
This is the form in both English & Spanish agreeing to participate in the Medicaid Pay-In Program
13 Apr, 2015 86 kb Downloads: 3563
Optional Pay-In Program for Individuals with Excess Income Download
MAP-931A Optional Pay-In Program searchable pdf.pdf
This explains the Excess Income Program for clients whose incomes exceeds the Medical Assistance income limits
13 Apr, 2015 142 kb Downloads: 3264
MAGI Consumers Long Term Eligibility Rules Download
2014-10-24 MAGI Consumers Long Term Eligibility Rules.pdf
long term eligibility rules for individuals who are eligible for Medicaid under a Modified Adjusted Gross Income (MAGI) eligibility group
09 Apr, 2015 74 kb Downloads: 5972
Nursing Home Eligibility Division Expedited Renewal Protocol Download
2015-03-31 NHED EXPEDITED RENEWAL PROTOCOL.pdf
HRA's policy regarding automated renewal for certain institutionalized Medicaid recipients. This alert identifies which nursing home residents are being selected for automated Medicaid renewals.
03 Apr, 2015 200 kb Downloads: 9019
NYC HRA MICSA ALERT 02 03-2015 Medicaid Recipients Transferred at Renewal from NYS of Health to Local Dept. of Soc. Services Download
2015-02-03 Medicaid Recipients Transferred at Renewal from the New York State of Health to the Local Department of Social Services.pdf
Procedure for transitioning people from expanded "MAGI" Medicaid generally for people under 65 who do not have Medicare -- when they turn 65 or become enrolled in Medicare, they must transfer to Non-MAGI Medicaid, using a stricter income and resource test. The procedure provides some coverage to fill the gap during the transition. It implements State DOH 14-LCM-02 posted at https://www.health.ny.gov/health_care/medicaid/publications/lcm/14lcm-2.htm (Dec. 2014)
23 Feb, 2015 143 kb Downloads: 6669
NYLAG Testimony on 2015-16 Proposed State Budget - Medicaid and Health Care Download
NYLAG Health statement 2015.pdf
Testimony by NYLAG on 2015-16 Proposed State Budget - Medicaid and Health Care. Opposes repeal of Spousal Refusal (and Parental Refusal) and repeal of a provision that requires expedited "immediate need Medicaid" services pending a final decision on a Medicaid application, where personal care or other services are urgently needed and the application is likely to be approved.
12 Feb, 2015 541 kb Downloads: 3633
Sample of a "WEP" Windfall Offset Notice for Social Security Download
WEP NOTICE reduction.pdf
Sample of a Social Security notice reducing the Social Security Retirement benefit because of a Ghetto pension received from Germany.
16 Dec, 2014 263 kb Downloads: 6660
Prev Next


This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelpny.org. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information. To report a dead link or other website-related problem, please e-mail us.