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Optional Pay-In Program for Individuals with Excess Income
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
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13 Apr, 2015
142 kb
Downloads: 3347
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Notice of Acceptance of your Medical Assistance Application/Recertification
MAP-259p_redacted.pdf
This is a redacted MAP-259p form to act as a guide for purposes of Medical Assistance application/recertification
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13 Apr, 2015
334 kb
Downloads: 4190
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Notice of Renewal of your Public Health Insurance Coverage
MAP 2088v_redacted.pdf
This is a redacted notice of renewal of public health insurance coverage to act as a guide to help clients fill out their renewals.
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13 Apr, 2015
882 kb
Downloads: 5672
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Formerly Incarcerated Individuals Reactivation Transmittal
map-3103 Formerly Incarcerated Individuals Reactivation Transmittal.pdf
This form was uploaded by NYC HRA on 2/20/15 to help formerly incarcerated individuals reactivate their medicaid account once they have been released.
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13 Apr, 2015
111 kb
Downloads: 3509
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Notice of Permanent Placement Medicaid Managed Care
MAP-2159i Notice of Permanent Placement Medicaid Managed Care.pdf
NYC HRA uploaded this form on 4/3/15 to be used for clients requiring permanent placement under Medicaid's managed care plan.
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13 Apr, 2015
36 kb
Downloads: 7934
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MAGI Consumers Long Term Eligibility Rules
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
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09 Apr, 2015
74 kb
Downloads: 6061
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8 Helpful hints for accurate completion of the medical request for home care (M11Q)
2014-12-09 8 Helpful HInts re Completion M11q.pdf
8 helpful hints for accurate completion of the medical request for home care (M11Q)
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09 Apr, 2015
61 kb
Downloads: 5623
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Consumers Whose Active Medicaid Coverage on the NYSOH (Marketplace) Must be Transitioned to WMS
2015-01-05 Consumers transitioned from NYSOH to WMS update (HIV SNP).pdf
Consumers who wish to enroll in an HIV SNP must also have their coverage transitioned to WMS.
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09 Apr, 2015
53 kb
Downloads: 4832
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CASA Fact Sheet
CASA FAct Sheet 2015.doc
Fact sheet describing what is covered under Housekeeping Services and where CASA offices are located
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09 Apr, 2015
30 kb
Downloads: 5519
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15-03-26 Relocation of HRA Headquarters
15-03-26 Relocation of HRA Headquarters.pdf
As of March 2, 2015, the Office of Legal Affairs has moved.
Their new contact information is:
HRA Office of Legal Affairs
ATTN: MICSA LPCU
150 Greenwich Street, 38th Floor
New York, NY 10007
Fax: (917) 639-0331
OLAMAReferrals@hra.nyc.gov
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03 Apr, 2015
266 kb
Downloads: 6702
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