New York Health Access - Recent Articles

Recent Articles

	Income and Resource Limits for New York State Public Health Insurance Programs Since Jan. 1, 2023, the income limit for the Aged, Blind and Disabled is 138% of the Federal Poverty Level (FPL -also known as "Federal Poverty Guidelines"). This is the same income limit used since 2014 for the younger "MAGI" Medicaid group under the Affordable Care Act (ACA).. (Read about how the...


	2026 UPDATE: Elimination of Requirement to Apply for Social Security and Maximize Other Benefits for Medicaid & MSP As of Jan. 2026, Medicaid and Medicare Savings Program (MSP) applicants and recipients are no longer required to pursue potentially available income, including Social Security and IRA distributions, as a condition of receiving Medicaid and MSP. This is from an amendment to federal Medicaid...


	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...


	Temporary Protected Status (TPS) and Public Health Insurance THE TRUMP ADMINISTRATION HAS ended Temporary Protected Status (TPS) for Haiti (ending March 16, 2026) and many other countries. See the USCIS website to see updates for particular countries. The information in this article below has not been updated to take into account the end of TPS. ...


	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...


	Sources of Legal Authority for Health Care Advocates Public health care programs in New York State are governed by many different legal sources. Because most programs, including Medicaid, are federal in origin, governing law begins with federal statute and regulation. State statutes are often very prescriptive as well, defining key terms such as...


	Medicaid Home-and-Community-Based Services (HCBS) Waiver Programs in New York State Dec 2025 ALERT: CMS has approved NYS DOH's proposal to cap the number of people who may enroll in the Nursing Home Transition & Diversion Waiver (NHTD). See more here. IN THIS ARTICLE Introdution to Home & Community Based Waivers Traumatic Brain Injury (TBI) waiver Nursing Home...


	2025 Medicaid Modernization in New York State: Medicaid Eligibility and Client Management System (MECM) For a background document comparing MAGI Medicaid, Non-MAGI Medicaid, and the Medicare Savings Program, click here. For an example MECM notice showing Medicaid and MSP eligibility, click here. For an example MECM notice showing Medicaid and MSP ineligibility, click here. For a copy of the slides...


	Medicaid Fair Hearings in NYS - Common Links and Changes Medicaid recipients have the right to request a Fair Hearing to appeal an adverse action. This includes decisions made by a managed care or Managed Long Term Care plan, by the local Dept. of Social Services, or by NYS's contractor, NY Medicaid Choice or the NY Independent Assessor. This is not...


	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...


	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 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...


	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...