Medicaid eligibility rules changed significantly on January 1, 2014 for some New Yorkers as a result of the Affordable Care Act’s eligibility expansion and streamlining provisions. The expansion only applies to a population called the "MAGI" population. Generally, the new rules do NOT apply to people over age 65 or who have Medicare at any age. There are limited exceptions to this. Various resources are available to explain the new rules and benefits:
NHeLP Advocates Guide to MAGI (updated 2018)( This August 2018 update addresses changes to MAGI under the Republican tax plan enacted last year, as well as recently passed legislation affecting MAGI-based calculations, including:
New tax filing threshold now set at $12,000 for individuals, which will lower total household income for some who claim tax dependents (this will lead to more people being eligible for Medicaid, Cost Sharing Reductions, and more generous Premium Tax Credits);
New rules for prorating lottery winnings in Medicaid instead of counting them as lump sum income;
New income exclusions for payments made under parent-mentor programs and for those participating in clinical trials
Link to NHELP WEBINAR On MAGI Budgeting Jan. 7, 2014
Click here for an interactive Marketplace eligibility questionnaire, designed to help enrollment assistors and consumers better assess their potential eligibility for Marketplace coverage based on immigration status, age and income. This questionnaire is not an official assessment of eligibility. To receive an official determination of eligibility contact the New York State of Health Marketplace at http://www.nystateofhealth.ny.gov or 1-855-355-5777
This training, Medicaid in 2014: Understanding MAGI & the Marketplace, covers the following topics, with case examples to help illustrate how the rules apply to our clients:
Empire Justice Center Reports on Immigrant Access to Health Care in NY's Health Insurance Exchange
Helpful MAGI worksheet from another state.. but should be valid in NYS