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NYS Medicaid Income and Resource Levels for Past Years - 2001 - 2016
2001_to_2016_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2001-2016. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
Past income levels since 2001 were until now posted in one document at http://health.wnylc.com/health/download/396/. That file got too big and now includes Medicaid charts from 2017 - 2025. This document includes earlier years back to 2001.
See current Medicaid income levels in this article http://health.wnylc.com/health/entry/15/
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19 Jan, 2026
1.83 mb
Downloads: 0
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NYS Medicaid Income and Resource Levels for Past Years - 2017 - 2024
2017_to_2025_NYS_income__resource_level_charts.pdf
Income and Resource levels for Medicaid and other public health programs in NYS for 2017- 2024. Includes Medicare Savings Programs, Family Health Plus, Child Health Plus, Spousal Impoverishment levels, MBI-WPD, etc.
File got too big to include all charts since 2001. Years 2001 -2016 now posted at http://www.wnylc.com/health/download/920/
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19 Jan, 2026
3.57 mb
Downloads: 303414
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Medicaid income and resource levels - 2026 (01-07-2026)
MAPDR-01 Jan 2 2026.pdf
NYC HRA MAPDR-01 (updated 01-2026 ) -- Although this was issued in Jan 2026, almost all the figures are in yellow which means that they are still the 2025 figures. The 2026 figures can only be calculated after NYS Dept. of Health issues the 2026 Federal Poverty Levels (FPL) later in February or March (even though the FPLs were announced by the federal govt).
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16 Jan, 2026
298 kb
Downloads: 455418
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MAP-2161 and MAP 2161a Spousal / Parental Refusal Form (2025) (ENGLISH)
MAP-2161 (2025-04) + MAP-2161a (2025-3) Combined (Spousal Refusal Form with INSTRUCTIONS.pdf
Applicants for Medicaid in New York City can use this "APPLICANT/RECIPIENT DECLARATION CONCERNING THE LEGALLY
RESPONSIBLE RELATIVE’S INCOME/RESOURCES" forms to indicate the refusal of their legally responsible relative to make available their income or resources for the cost of necessary medical care and services, i.e. "spousal/parental refusal." Since 2018, includes language to request accommodation of disability in reading notice. Instructions explain whi h form to use - MAP-2161 or 2161a - don't need both. Both attached in same PDF. Other languages availaable of MAP-2161 at https://www.nyc.gov/site/hra/help/health-assistance.page
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13 Jan, 2026
371 kb
Downloads: 69830
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2024-10-1 Medicaid Alert - Nursing Home Eligibilty Dept. Provider Relations (NHED PR) - Email Inquiries Transitioning to MCS (Managed Care System)
2024-10-1 NH transition from provider relations email inbox to mcs october 1 with fillable form.pdf
Alert announces a new portal for which providers and organizations assisting consumers must be approved to access information from the Nursing Home Eligiblity Dept. Includes a form to complete and submit by email to nhedproviderrelations@hra.nyc.gov. See instructions in the Alert. "Provider name" would be the name of the law firm or org.
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12 Nov, 2025
201 kb
Downloads: 174
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MAP-751k (Spanish)(11-27-2024)(fill-able))
MAP-751K Spanish (11-27-2024)(fill-able).pdf
NYC HRA Form to use to notify HRA of change in name, address, mailing address, date of birth, SSN, and to request mail in different languages or formats for disability) . Other languages are available at https://www.nyc.gov/site/hra/help/health-assistance.page. NOTE: The 751k is no longer used to request a change in budgeting. Instead use new form MAP-751W available at https://www1.nyc.gov/site/hra/help/health-assistance.page in various languages
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30 Sep, 2025
206 kb
Downloads: 2204
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MAP-751K Consumer Request to Change Information on File (11-27-2024)(fill-able)
MAP-751K (11-27-2024)(fill-able).pdf
NYC HRA Form to use to notify HRA of change in name, address, mailing address, date of birth, SSN, and to request mail in different languages or formats for disability (Updated 11-27-2024. The MAP-751K is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages. Fax to HRA MAP Undercare 1-917-646-0837 per Medicaid Alert 8/2024 http://www.wnylc.com/health/download/738/. NOTE: The 751k is no longer used to request a change in budgeting. For that, use new form MAP-751W posted at the same webpage as above for the 751K
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30 Sep, 2025
199 kb
Downloads: 10867
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MAP-751W Consumer/Provider Request to Change Information on File (7-14-2025)(fill-able)
MAP-751W Request to Change Information (Doc required) (7-14-2025)(fill-able).pdf
NYC HRA Form to notify HRA of corrections or changes, e.g. close case, combine case, add/remove individual, notify of death, change in immigration status, upgrade eligibility, request MSP evaluation, budgeting changes, pooled trust budgeting and add/remove third party health insurance. may be faxed to Fax 1-917-646-0837 per August 2024 Medicaid Alert http://www.wnylc.com/health/download/738/. Note that a change in demographic information (such as name, address, phone number) should be reported in a different form: MAP-751K.
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30 Sep, 2025
225 kb
Downloads: 11496
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NYC Medicaid Alert jULY 25, 2025 Medicaid Program (MAP) Fair Hearing Relocation
2025-07-25 HRA MAP fair hearing relocation update.pdf
Contact info and locations for MAP Fair Hearing Conference Unit, Compliance and Aid Continuing Unit, Fair hearing Representation Unit, and Records Request Unit. INcludes updated info on how to request a Fair Hearing and a new FAX NUMBER to request case records for a conference or hearing. REPLACES alert dated 12/17/2024
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29 Sep, 2025
159 kb
Downloads: 878
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NYC Medicaid Alert - Fair Hearing Relocation Update July 25, 2025
2025-07-25 HRA MAP fair hearing relocation update.pdf
Annouces relocation of certain NYC HRA Fair Hearing units within NYC. This is not about where the STATE Fair Hearing office is in NYC - but the NYC HRA Medicaid division that produces case files for Medicaid fair hearings, handles compliance, aid continuing, and represents HRA at fair hearings. -- All contacts posted at http://health.wnylc.com/health/entry/216/#Fair%20Hearings
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29 Jul, 2025
159 kb
Downloads: 470
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