This article available as a fact sheet in ENGLISH and SPANISH
This article is for people whose Medicaid is administered by the NYC Medicaid program, run by the Human Resources Administration (HRA). If your Medicaid is handled by the New York State of Health – your renewal is not covered in this article. The process is different outside NYC, though the general principles are the same.
Medicaid is authorized for one year at a time. Approximately 3 – 4 months before the end of your “authorization period,” you should receive a "renewal" packet by mail, which includes instructions on how to complete and return the packet to HRA. This process is also called “recertification.” Here are tips for handling renewals, including how to obtain a copy of the renewal form if you don’t receive one in the mail.
New April 2023 - NYC Medicaid renewals can be uploaded ONLINE on AccessHRA website along with their documents! Click here for more info about this new option starting April 2023.
Download sample renewal form as revised in 2022. See the new Authorization for Verification of Resources form that you and your spouse must each sign and return with the renewal.
COVID PANDEMIC ALERT - RENEWALS RE-STARTING WITH UNWINDING OF THE COVID PUBLIC HEALTH EMERGENCY
Keep track of your Medicaid authorization period so you know when to expect your Medicaid renewal
Obtain Your Renewal Packet if you Don't Receive it In the Mail
How to Fill Out The Renewal Form --new Authorization for Verification of Resources form that you and your spouse must each sign and return with the renewal.
1. COVID PANDEMIC ALERT - MEDICAID RENEWALS STARTED AGAIN in March 2023 - UnWINDING of the Public Health Emergency--
Starting March 2020, all Medicaid cases were automatically extended for 12 months, because Medicaid could not be discontinued or reduced during the "Public Health Emergency." See GIS 20 MA/04, GIS 20 MA/11 and more here. Since March 2020, most counties in NYS stopped sending the renewals entirely. NYC HRA still sent out the renewal packets as usual, but even if the consumers don't return it, the Medicaid office (HRA in NYC) MUST recertify Medicaid coverage for 12 months.
March 2023 starts the "unwinding" of the Public Health Emergency. MEDICAID RENEWALS are starting again. See NYS DOH Jan. 13, 2023 Memo and Unwinding Timeline:
March 2023 - Renewals wil start in March 2023 in NYC and April 2023 in the rest of the state. All 7+ million Medicaid recipients will receive renewals over a 12-month period.
Medicaid-only cases with authorization ending 6/30/23 or later need to submit their renewals on time, with the required documentation. Otherwise, Medicaid can be discontinued.
Medicaid-only cases with authorizations ending 5/30/23 or earlier should still be extended automatically, with the same spend-down as before, even if the consumer does not return the renewal or even if the consumer is no longer eligible.
July 2023 - The first discontinuances of Medicaid for those determined to be no longer eligible based on their renewal, or who do not respond to the renewal, start in July 2023. They must be sent advance notice with fair hearing rights 10 days in advance. At the same time, those whose spend-down INCREASES from the former amount will receive notice of the increase starting effective July 1, 2023. Because of the 2023 increases in income limits, few people should see an increase in their spend-down.
CONSUMERS MUST UPDATE THEIR ADDRESS on FILE WITH MEDICAID OFFICE !! Otherwise, they will not receive the Renewal forms and will lose Medicaid.
See this article for all COVID-19 info related to Medicaid and home care.
Find the starting month of your authorization period on your Medicaid acceptance letter. The attached sample Notice of Decision on Your Medical Assistance (p. 6 of PDF) is dated July 31, 2019, and the starting month of the Medicaid authorization is July 1, 2019. The one-year authoriation period ends June 20, 2020. Pretending COVID hadn't happened -- the next renewal would have been sent in March or April 2020 with a return due date of May 10, 2020. If that renewal wasn't returned, a notice of discontinuance would have been sent June 20, 2020 effective July 1, 2020.
For another example of timing -- see the sample notices at pp. 7-8 of this PDF. These are the notices a consumer would receive if their previous authorization period was from Sept. 1, 2018 to August 31, 2019.
p. 7 - Renewal Notification dated July 10, 2019 with renewal due August 10, 2019.
p. 8 - Notice of Decision on Your Medical Assistance dated Aug. 21, 2019 with Medicaid discontinuing effective Sept. 3, 2019. Discontinuance is because renewal not returned by August 10, 2019.
Find the date your authorization period ends in your account on the AccessHRA website. Once you log in, on the home page, click on RENEW MEDICAID button. Here you can view your Medicaid case information including: Recert Due Date (currently named Eligibility End Date),
If you are enrolled in an MLTC plan, your MLTC plan should notify you of an upcoming renewal shortly before HRA mails you the renewal packet.
If you receive your renewal packet in the mail, don’t throw out the enclosed gray return envelope. As explained below, you will send back the completed renewal packet in the gray envelope. See more here about option to file the completed renewal ONLINE.
Set up an account on the ACCESS HRA Website following this link. To set up an account, you will need to create a username, password, and select a security question. You DO NOT need an email address to set up an account. Once you create an account and log in, you may be asked to enter your date of birth and Social Security Number or CIN. Please enter this information to locate your case in HRA’s system.
You will then be able to download and print your individualized renewal form. Use this personalized renewal form instead of a new Application, as your renewal packet has a unique barcode and other information that is specific to your case.
If you are unable to use the Access HRA website, request a copy of your renewal packet by calling HRA’s automated line at 1-888-692 6116.
If you recently moved and have not updated your address with HRA, you will not receive your renewal, as it will be mailed to your last known address.
If your renewal period is coming up in the next 4 months, use Access HRA to download a copy of the renewal form (see No. 2a above).
If you won’t be receiving your renewal for at least 4 months, report your new address to HRA immediately. Call the Medicaid helpline at 1-888-692-6116 to update your address or complete and fax the MAP-751K form to fax 1-917-639-0837. Download the form in English and other languages on HRA site at this link. (Form updated 3-15-2021)(Check back to see if HRA updates the form). Please make sure to keep fax confirmation.
See this HRA Alert 6/30/23 which provides for protections for consumers whose renewal packets are returned by USPS.
Click here for option to UPLOAD the renewal and supporting documents online - new April 2023.
WRITE in big, clear letters on top of the form and in any white space if you get any special type of Medicaid budgeting -- such as “Spousal Impoverishment,” “Spousal Refusal,” “MBI-WPD,” “Pooled Trust,” “MAGI-like,” DAC, Pickle, or “Special MLTC Housing Standard.” Also write in if you want QMB (Medicare Savings Program) as well as Medicaid. For info about these special Medicaid budgeting rules, see this article
Include all household members and their information. This includes your spouse if your spouse lives with you, and any minor dependent children (or grandchildren or other relatives) under age 18 or under 19 if in school who live with you. Do not list your adult children, your siblings, or other roommates.
Make any changes to the amount of your rent, your insurance premiums, your income, and your resources.
If you have a Pooled Income Trust, be sure to check the box saying you are enclosing a Verification of Deposits that you obtain from your Pooled Trust organization reflecting all deposits you have made for the last year. Many Pooled Trusts now make this document available online for download.
NEW IN 2023 - Authorization for Verification of Resources - If this form is in the packet, the recipient and their spouse if they are married each must sign this form and send it back with renewal! (MAP-3179 is for applicant and 3179a is for spouse) (pp. 11-13 of PDF). The renewal form has a new section to provide the spouse's name, date of birth, Social Security Number and address. This is in Part 6 RESOURCES (Page 6 of the PDF). This authorization is likely being required as HRA is belatedly implementing the Asset Verification System (AVS) required by NYS DOH 17-ADM-02. See more about this here.
Financial Maintenance Form -- If your share of household expenses for rent and utilities are more than 70% of your monthly gross income, fill out the Financial Maintenance Form included in the packet to explain how you meet your expenses. (Form is page 10 of this PDF) If someone pays one or more of your bills, write “paid for by ______.” You may want to include a letter from this person stating that they pay this bill on your behalf.
If you have a Pooled Income Trust, include a current Verification of Deposits for the last year through the current month. Ask your Trust Organization for this form. Many Pooled Trusts now make this document available online for download.
Proof of payment of health insurance premiums. (Ex: Medigap, dental, vision, union/retirement, etc.). Note: this proof may appear in your pay stub.
Proof of income for all of your household members, including: pension letter, letter from employer, paystubs, etc. You do not have to include a letter showing your current Social Security amount, but it is a good idea to include anyway.
If you have an I.R.A., include the most recent statement that shows the amount of your Required Minimum Distribution (RMD) for the current year. Include proof that you are taking or that you have requested regular periodic distributions.
Proof of resources -- current bank and investment account statements that you or your spouse own, even if you own them jointly with someone else. Include a statement of your burial fund account if you have one.
If applicable, a copy of the signed Spousal Refusal form, if any, even if you submitted it before.
If you are in an MLTC plan and have the Special Income Standard for Housing Expenses because you were in a nursing home or adult home in the past, you need to complete, sign and include this form.
Include the Authorization for Verification of Resources form signed by you and your spouse if it was in the packet.
BEST PRACTICE TIP: Write clearly on top of the renewal form and, if you wish, in a cover letter, if you are requesting any special budgeting (see #4.a. above). If you include a cover letter, explain the proposed budget to demonstrate that the spend-down should be zero. Make clear if you want the Medicare Savings Program too.
Click here for option to UPLOAD the renewal and supporting documents online - new April 2023.
If returning the renewal by mail -- make two complete copies of the signed renewal form and all attachments.
Mail the original renewal packet and all required documents to HRA in the barcoded gray envelope you received in the mail. If you downloaded the form and you do not have the return bar-coded envelope, then mail it to the address below.
Mail another complete copy of the renewal packet and all attachments in a separate envelope to the same address via certified mail return receipt requested so you have proof you sent it and when it was received. Save the return receipt.
After you send your renewal packet, you can call the automated line at 1-888-692-6116 to check the status of your renewal. Have your Medicaid case number available, which can be found on the top right corner of your renewal form. Be advised it may take some time for the renewal packet to be received and processed.
Medicaid-only Disabled Aged and Blind (DAB) consumers can submit their Medicaid renewal online using ACCESS HRA as an alternative to returning the paper forms. (see NYC HRA ACCOUNCEMENT -- 2023-04-07 ACCESS HRA Client Portal Enhancements.
WHO: Medicaid-only cases with authorization ending 6/30/23 or later, can submit their renewal on ACCESS HRA. This is the renewals being sent in March 2023 that are due back May 10, 2023. And all renewals from then on can be filed online.
This includes Medicaid Excess Income or Surplus program and those that receive homecare services through a Managed Long Term Care (MLTC) plan)
HOW: Create an account at www.nyc.gov/accesshra. To set up an account, you will need to create a username, password, and select a security question. You DO NOT need an email address to set up an account. Once you create an account and log in, you may be asked to enter your date of birth and Social Security Number or CIN. Please enter this information to locate your case in HRA’s system. On the home page, click on RENEW MEDICAID button. Consumers can view their Medicaid case information including: Recert Due Date (currently named Eligibility End Date), Surplus coverage status and Surplus amount. More information on how to file the renewal online will be posted here soon.
WHO DOES NOT NEED TO SUBMIT RENEWALS YET - All active Medicaid-only cases with authorization end dates 3/31/20 through 5/31/23, will continue to be systemically extended for 12 months and individuals still will not be required to renew their Medicaid eligibility because the COVID rules are still in effect.
NEW - Can PAY-IN Spend-down online too. When logged into www.nyc.gov/accesshra -the “Make a Payment” button in the right navigation links to CityPay portal which allows Surplus clients to pay their Surplus. However, consumers that have never submitted a payment through the Division of Accounts Receivable & Billing (DARB), must contact DARB to be registered prior to submitting an online payment at 718-557-1399.
You did not receive your renewal form by mail or if you recently moved? See here
You receive a Notice that your Medicaid will be discontinued for failure to renew, even though you sent in your renewal? Sometimes this happens even when you submit your renewal on time -- because the computer is programmed to send them out automatically. See a sample Notice of Decision on Your Medical Assistance at page 8 of this fact sheet. On this sample notice:
WHEN to REQUEST THE FAIR HEARING -- The State hearing agency (NYS Office of Temporary & Disability Assistance or OTDA) must RECEIVE your fair hearing request before the Effective Date of the case closing (Sept. 3, 2019 in the sample at page 8 here). Then your Medicaid will continue until the fair hearing is held and decided. This is called “Aid Continuing.”
HOW TO REQUEST THE FAIR HEARING - by phone, fax, or online at https://otda.ny.gov/hearings/request/. Mail is not recommended as it may arrive too late for you to get Aid Continuing. Include a copy of your NOTICE, and write the date of the notice, the effective date, and the notice number on the Fair Hearing Request. The State hearing agency OTDA will alert HRA staff to keep your case open and your coverage active.
Find help for the hearing at https://www.lawhelpny.org/.
Proof that you submitted your renewal on time (or within the 30-day grace period) will be important to win the hearing. Sometimes your advocate can help you avoid having a fair hearing altogether—but you must request the hearing with Aid Continuing right away to prevent loss of Medicaid and home care services.
WARNING: If you received the Notice that your Medicaid will be discontinued, and if you did not send in the renewal, you must request a Fair Hearing before the case closing date to ensure your Medicaid case does not close. You should also submit the renewal to HRA within the 30-day grace period, if there is still time. But do not only submit the renewal even if you are in the grace period, or your Medicaid may be discontinued. Request a Fair Hearing too!
* * *
For questions -- contact the NYLAG Evelyn Frank Legal Resources Program:
212-613-7310 or eflrp@nylag.org (Monday 10 AM – 2 PM)
Check out http://www.wnylc.com/health/
This fact sheet is available online here in English and Spanish
Check online for updates!