New York Health Access - Recent Articles

Recent Articles

	Special Medicaid Income Rules That May Eliminate Your "Spend-down" or "Surplus Income" Many people age 65+, Disabled or Blind would normally have an income "spend-down" because their income is above the non-MAGI limits (which are in BOX 1 of the HRA Income & Resources chart ). This Fact Sheet explains the basic rules of Non-MAGI Budgeting used for people age 65+, Disabled, or...


	The Medicaid Buy-In for Working People With Disabilities (MBI-WPD) The Medicaid Buy-in for Working People with Disabilities (MBI-WPD) expands eligibility for individuals with disabilities under age 65 who have work income. Under MBI-WPD, individuals are eligible for full Medicaid benefits at much higher incomes than individuals who are not working. The income...


	2026 Medicare Part D Plans in New York State - with changes from 2025 The Annual Enrollment Period ("AEP" or "open enrollment") for Medicare Part D and Medicare Advantage plans for 2026 runs from October 15 through December 7, 2025. For 2025 plan lists click here. Read below for 2026 plan lists. Every year, you should review your plan options to see if your...


	Medigap (Medicare Supplemental) Policies and Rates in New York State - with Rate Tables for the Current Year Medigap (aka Medicare supplemental insurance) policies are sold by private health insurance companies to cover some of the "gaps" in expenses not covered under original Medicare. Different Medigap policies in New York State and their Cost. Under federal law, all Medigap plans have standard...


	Patients' Rights in the Health Care System See NYS Dept. of Health Webpage on Patient Rights in NYS Managed Care Bill of Rights New York State has a fairly progressive managed care bill of rights which is found in both the Public Health and Insurance laws. Disclosure. Managed care plans must tell their patients about the coverage...


	Medicaid Contacts in New York City (NYC Human Resources Administration - MICSA) August 5, 2024 - address for main NYC Medicaid Office - called the Brooklyn South Medicaid office - has been changed to 495 Clermont Avenue, Brooklyn, NY 11238. This is around the corner from the previous address on Atlantic Avenue since 2013 see 2024-08-02 Change of address for Brooklyn_South...


	Medicaid Consumer Directed Personal Assistance Program (CDPAP) in New York State - Big Changes Coming 2025! For updates about the transition to the new NYS "Single Fiscal Intermediary" (FI) and NYLAG's lawsuit challenging it - please see This article for latest news and this article for the history of the transition to PPL starting in 2024 with links to press coverage. Also see...


	CDPAP: April 2025 Transition to PPL as Single Fiscal Intermediary - Background, Press & Archive Background. The 2024-25 NYS Budget required all 280,000 Medicaid recipients who have CDPAP services to switch their "Fiscal Intermediary" (FI") the agency that manages payroll and benefits for their Personal Assistants ("PA") to a new "single FI" called Public Partnerships LLC or "PPL." FI's have...


	List of Pooled SNTs in New York State This is an unofficial list of non-profit organizations in New York State that offer pooled Supplemental Needs Trusts (or similar services) to people with disabilities. We do not claim that this is an exhaustive list; there may be other pooled trusts in the state of which we are unaware. In...


	Managed Long Term Care State Complaint Unit for MLTC Problems - 1-866-712-7197 e-mail address is changing Nov. 1, 2025 Until Nov. 1, 2025 mltctac@health.ny.gov. After Nov. 1, 2025 MLTCComplaints@health.ny.gov Enrollment complaints - call NY Medicaid Choice - 1-855-886-0570...


	When an MLTC Plan Closes - What are the Members' Rights? WARNING - Changes Now in Effect Since Managed Long Term Care (MLTC) plan enrollment has been mandatory since 2013 for most adult "dual eligibles" (people with Medicaid and Medicare) who need Medicaid home care, some MLTC plans have either closed or reduced their service area, no longer covering certain counties or New York City....


	Spousal Impoverishment Protections for Married Couples where One Spouse is in a Managed Long Term Care Plan or HCBS Waiver- Pooled Trusts Allowed as an Option In this Article KNOW YOUR RIGHTS: Download Consumer Fact Sheet on Tips for Keeping More Income, including Spousal Impoverishment Protections.: What are Spousal Impoverishment Rules? Which Married couples can Use Spousal Impoverishment Protections? Spousal Impoverishment...


	"HARP" Plans for Managed Care Members who need Behavioral Health Services - 2026 Changes for Members New to Medicare For many years, behavioral health services were "carved out" of the Medicaid managed care benefit package. This means that most behavioral health services were accessed on a fee for service basis from Medicaid providers outside of the member's managed care plan. In this Article: What is a...


	Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Note: For a quick introduction to EPSDT, see the attached powerpoint titled "NYLAG Presentation on EPSDT." Please feel free to share those slides, as well as the material below, widely. In this article: Part 1 - Basics about EPSDT Requirements Part 2 - Select Services that Must be Covered...


	Getting Help with Managed Long Term Care and Other Types of Medicaid Managed Care Here are organizations where you can seek help for problems with Medicaid Managed Long Term Care (MLTC) plans, Medicaid Advantage Plus (MAP) plans, and Mainstream plans. Also see these KNOW YOUR RIGHTS Fact Sheets about MLTC and related topics STATEWIDE ICAN –...


	KNOW YOUR RIGHTS: Managed Long Term Care - Fact Sheets, Live and Recorded Webinars A. Fact Sheets on Managed Long Term Care B. Click here for WEBINARS on LONG TERM CARE A. Fact Sheets on Managed Long Term Care BASICS Basics on Managed Long Term Care (In process of being updated - 2-2020) see also Article on Managed Long Term Care News on MLTC - updated monthly ...


	ARCHIVE: US Lawsuit Against NYC for "False Claims" - Says HRA Wrongly Approved 24-Hour Medicaid Home Care On August 12, 2011, Selfhelp Community Services, New York Lawyers for the Public Interest, Legal Services-NYC, and Cardozo Bet Tzedek Legal Services led 41 organizations in filing an amicus or "friend of the court" brief supporting the New York City Medicaid Program, run by the Human Resources...


	Statistics on Medicare and Medicaid Managed Care -- Enrollment Numbers and other Data -- New York State Numbers tell a big part of the story of how managed care plans are doing in providing care. With mandatory enrollment in Medicaid managed care now required in every county in New York State for most people who do not have Medicare, and mandatory enrollment in Managed Long Term Care of those adults...


	Right to a "Home Hearing" under Varshavsky Case - Special Rights in Fair Hearings Seeking Increases in Medicaid Home Care RIGHTS of People Who Cannot Travel to a Fair Hearing Because of Disability This article can also be downloaded as a Fact Sheet here. Individuals who, because of mental or physical disabilities, cannot travel to a fair hearing without substantial hardship or medical detriment, have rights...


	Medicaid Reimbursement of Home Care and other Medical Expenses Reimbursement in General Because Medicaid coverage can be retroactive up to three months, it is possible for a Medicaid applicant or his or her family member who paid the applicant's medical expenses to get reimbursed for some of the home care costs and other medical bills they incurred and paid...


	KNOW YOUR RIGHTS: Fact Sheet Explaining Basic Rules on NYS Financial Medicaid Eligibility for People who are Disabled, Aged 65+, or Blind This Fact Sheet (updated 03/05/2025 with 2025 figures) explains Medicaid eligibility for New Yorkers who are age 65+ or who have disabilities. It explains the basic financial rules on eligibility for Medicaid in the community for this category of people, and explains how to apply for Medicaid if...


	Medicaid Alerts & Other Protocols published by the NYC HRA Medicaid Program HRA Medicaid Alerts are periodic announcements of policy, staff and office changes published by the HRA Medicaid Progarm (MAP) (formerly called the "Medical Insurance and Community Services Administration (MICSA)". The Medicaid Program is the part of New York City’s Human Resource...


	"Immediate Need" Fast-Track Application for Medicaid and Personal Care or CDPAP - Choices for those with full Medicaid start April 2024 Medicaid has a fast-track procedure to apply for Medicaid in order to obtain home care services, which has been faster than enrolling in a managed long term care plan. Click here to learn about the reasons for MLTC enrollment delays. The 2015 New York law requires approval of Medicaid in only...


	Transfer of Asset Rules in Medicaid -- The Deficit Reduction Act of 2005 The Deficit Reduction Act of 2005 (DRA, enacted in 2006, made major changes to the transfer penalty rules for eligibility for Medicaid to pay for nursing home care. At the time, and until now, nursing home care was the only Medicaid service that had a lookback and transfer penalty.See GIS 06...


	Providers Must be Enrolled in NYS Medicaid Program to ORDER/PRESCRIBE/REFER/ATTEND Medicaid Services - Including Providers in Managed Care Plans - also Tool to Find Medicaid Providers What types of providers are affected? Effective January 1, 2014, medical providers must be enrolled with the NY State Medicaid program in order for Medicaid to pay for services that they prescribed, ordered or referred. The rule applies to ordering, prescribing, referring and attending...