How to Apply for Medicaid in New York
Last updated: February 2026
Disclaimer: This guide provides general information about Medicaid in New York and is not legal or financial advice. Eligibility rules can change, and individual circumstances vary. Always verify current requirements with NY State of Health or your local Department of Social Services before applying.
Figuring out how to apply for Medicaid in New York can feel overwhelming when you're dealing with financial stress and don't have health coverage. The good news is that New York has one of the most accessible Medicaid programs in the country, and applying is more straightforward than you might expect.
Here is what you need to know upfront: You can apply for Medicaid in New York online at nystateofhealth.ny.gov or mybenefits.ny.gov, and the application takes about 30 to 45 minutes. New York expanded Medicaid under the Affordable Care Act, which means adults earning up to 138% of the federal poverty level qualify for coverage. For a single person, that is about $21,597 per year. For a family of four, the income limit is $44,367 per year. Children qualify at even higher income levels, up to 154% of poverty.
Over 7 million New Yorkers receive Medicaid coverage, making it the largest health insurance program in the state. Enrollment is open year-round, so you do not need to wait for a special enrollment period.
This guide walks you through the eligibility requirements, documents you will need, and exactly how to submit your New York State Medicaid application.
Who Qualifies for Medicaid in New York
New York Medicaid covers a broad range of residents, including adults, children, pregnant women, seniors, and people with disabilities. As a Medicaid expansion state, New York provides coverage to adults that many other states do not cover.
To qualify for Medicaid in New York, you must be a New York State resident. You must be a U.S. citizen or have qualifying immigration status. You must meet the income requirements for your household size and category. There is no waiting period for new residents.
Adults ages 19 to 64 without dependent children can qualify if their income is at or below 138% of the federal poverty level. This expansion category is sometimes called Medicaid for adults or Essential Plan Basic. Parents and caretaker relatives qualify under similar income rules.
Children have more generous eligibility. Kids ages 1 through 18 qualify if household income is at or below 154% of poverty. Infants under age one and pregnant women qualify with income up to 218% of poverty, giving expectant mothers access to prenatal care regardless of their documentation status in some cases.
Seniors age 65 and older and people with disabilities have different income rules and may also face asset limits. These categories often qualify for additional benefits beyond standard Medicaid.
Understanding the specific income limits helps you determine where you fall in the eligibility spectrum.
New York Medicaid Income Limits 2026
New York sets Medicaid income limits based on the federal poverty level, which updates each year. The limits shown below reflect 2025 FPL guidelines used for 2026 coverage determinations.
Income Limits by Category
| Category | % FPL | Single Person | Family of 4 |
|---|---|---|---|
| Adults (19-64) | 138% | $21,597/year | $44,367/year |
| Children (1-18) | 154% | N/A | $49,511/year |
| Infants under 1 | 218% | N/A | $70,087/year |
| Pregnant Women | 218% | $34,117/year | $70,087/year |
For Medicaid, income is calculated using Modified Adjusted Gross Income (MAGI). This includes wages, self-employment income, Social Security benefits, unemployment compensation, and most other taxable income. It does not include Supplemental Security Income (SSI), child support received, or workers' compensation.
Asset Limits
Most Medicaid applicants in New York do not face asset tests. The MAGI-based Medicaid categories covering adults, children, and pregnant women have no asset limits. You will not be disqualified for having savings, a car, or owning your home.
However, Community Medicaid for seniors and people with disabilities does have asset limits. In 2025, individuals can have up to $32,396 in countable assets. Couples face a community spouse resource allowance calculated at 50% of joint assets. Your primary home, one vehicle, and retirement accounts are generally exempt from these asset limits.
If your income is slightly above the Medicaid limits, New York offers another option that many states do not have.
New York's Essential Plan
New York's Essential Plan provides low-cost health coverage for residents who earn too much for Medicaid but still need affordable insurance. This program is unique to New York and offers exceptional value.
The Essential Plan covers individuals and families with income between 138% and 250% of the federal poverty level. For a single person, that is income between $21,597 and $39,125 per year. For a family of four, the range is $44,367 to $80,375 per year.
Premium costs are $0 per month for most Essential Plan members. There are no deductibles. Copays range from $0 to $25 depending on your income level and the service. The plan includes dental and vision coverage at no additional cost.
Like Medicaid, the Essential Plan has year-round enrollment. You can apply anytime through NY State of Health at nystateofhealth.ny.gov. If your application shows you do not qualify for Medicaid, you may be automatically enrolled in the Essential Plan if your income falls in the eligible range.
Now let us look at what documents you will need for your Medicaid application.
Documents You Need to Apply
Gathering your documents before starting the application saves time and prevents delays. NY State of Health will verify much of your information electronically, but having documentation ready helps if verification issues arise.
Identity Verification
You will need a driver's license, state ID, passport, or other government-issued photo ID. A Social Security number is required for anyone applying for coverage. If you are applying for a child, you will need their Social Security number as well.
Proof of Income
Income documentation depends on your employment situation. If you are employed, bring recent pay stubs covering the last 30 days. Self-employed applicants should have tax returns or profit and loss statements available. If you receive Social Security, unemployment, or other benefits, have documentation of those amounts.
New York often verifies income electronically using federal and state data sources. In many cases, you will not need to submit income documents unless the system cannot verify your information automatically.
Proof of Residency
You will need to show you live in New York State. A utility bill, bank statement, lease agreement, or piece of mail with your New York address works for this purpose. New residents can use a lease or other documentation showing they have established residency.
Immigration Documentation
If you are not a U.S. citizen, you will need to provide documentation of your immigration status. This includes your alien registration number, I-94 card, or other USCIS documentation. Certain categories of immigrants qualify for full Medicaid. Others may qualify for emergency Medicaid only.
With your documents ready, you can proceed to submit your application.
How to Apply for Medicaid in New York
New York offers multiple ways to apply for Medicaid. The online application is the fastest option for most people, but phone and in-person assistance are available for those who prefer them.
Online Application
The quickest way to apply for Medicaid in New York is online through NY State of Health at nystateofhealth.ny.gov. The website is available 24 hours a day, 7 days a week. You can start an application, save your progress, and return later if needed.
You can also apply through mybenefits.ny.gov, which handles multiple benefit programs including Medicaid, SNAP, and HEAP. This portal connects to the same eligibility system and can be useful if you are applying for multiple programs.
For New York City residents, ACCESS HRA provides another online application option. This portal is specifically designed for NYC residents and connects to local Department of Social Services offices.
Phone Application
Call 1-855-355-5777 to apply by phone through NY State of Health. Representatives can walk you through the application and answer questions about eligibility. Phone lines are open Monday through Friday from 8 AM to 8 PM, and Saturday from 9 AM to 1 PM.
The NYC Human Resources Administration can be reached at 311 for New York City residents seeking assistance with their applications.
In-Person Application
Visit your local Department of Social Services office to apply in person. Bring your identification, income documentation, and proof of residency. Staff can help you complete the application and answer questions on the spot.
NY State of Health has certified enrollment assistors and navigators throughout the state who provide free application assistance. These trained counselors can help you understand your options and complete your application correctly. Find local assistance at nystateofhealth.ny.gov or by calling 1-855-355-5777.
Community health centers, hospitals, and community organizations often have enrollment assistors on staff who can help with applications at no cost.
Tips for a Smooth Application
Answer all questions completely and accurately. Incomplete applications cause delays. Double-check that names, dates of birth, and Social Security numbers are entered correctly.
Report all income for everyone in your household. Underreporting income can result in denial or having to repay benefits later. The system will verify income against tax records and wage databases.
Apply for all household members at the same time when possible. This helps ensure everyone gets appropriate coverage and that household income is calculated correctly.
Let us look at what happens after you submit your application.
What Happens After You Apply
After submitting your Medicaid application, NY State of Health processes your information and determines your eligibility. Most applications are processed within 10 to 45 days, depending on complexity.
Immediate Eligibility Determination
Many applicants receive an eligibility determination immediately after completing the online application. If the system can verify your identity and income electronically, you may see your results on screen right away. This instant determination is one advantage of New York's integrated eligibility system.
If Additional Information Is Needed
Sometimes NY State of Health needs additional documentation to verify your information. If this happens, you will receive a notice explaining what is needed and how to submit it. Respond promptly to avoid delays. You can upload documents online, fax them, or mail them to the address provided.
Enrolling in a Health Plan
Once approved for Medicaid, you will need to choose a managed care health plan. New York Medicaid is primarily delivered through managed care organizations that coordinate your healthcare services. You will receive information about available plans in your area and have a window to make your selection.
If you do not choose a plan, one will be assigned to you. You can change plans later if the assigned plan does not meet your needs, but choosing proactively ensures you get a plan with your preferred doctors in network.
Coverage Start Date
Medicaid coverage typically begins the first day of the month in which you are determined eligible. In some cases, coverage can be backdated up to three months to cover medical expenses you incurred before applying.
If you are pregnant, coverage begins immediately upon approval and continues through the pregnancy and 60 days postpartum. Children also receive coverage starting immediately upon eligibility determination.
Before completing the full application, you may want to check your eligibility first.
Check Your Eligibility
A free eligibility screening can help you understand whether you qualify for Medicaid and other programs before you invest time in a full application.
Tools like Benefits USA check your eligibility for Medicaid along with 10+ other benefit programs including SNAP food assistance, HEAP heating assistance, and tax credits like the Earned Income Tax Credit. You will see which programs you likely qualify for and their estimated annual value to your household.
These screenings take just a few minutes and require no personal information beyond household size and income. They are not official applications, but they help you understand what is available before starting the formal process.
If the screening shows you are likely eligible for multiple programs, you can apply for several through mybenefits.ny.gov at the same time, saving effort and ensuring you do not miss benefits you qualify for.
Understanding related programs helps you maximize your benefits.
Other Programs You May Qualify For
If you qualify for Medicaid in New York, you may automatically qualify for other benefit programs. New York makes it easy to apply for multiple programs through the same portals.
SNAP (Food Assistance)
SNAP provides monthly food benefits loaded onto an EBT card. New York has expanded SNAP eligibility, with income limits around 200% of poverty for households with elderly or disabled members. A family of four can receive up to $994 per month in SNAP benefits. Apply through mybenefits.ny.gov.
HEAP (Heating Assistance)
The Home Energy Assistance Program helps pay heating and cooling bills. Income limits are generous, up to approximately 60% of state median income. The average regular HEAP benefit in New York ranges from $400 to $900 depending on fuel type. Apply through mybenefits.ny.gov when the program opens each December.
Child Health Plus
If your children do not qualify for Medicaid because household income is too high, Child Health Plus covers children in families earning up to 400% of poverty. Premiums range from free to $60 per child per month depending on income. Apply through NY State of Health.
WIC (Women, Infants, and Children)
WIC provides nutritious foods, nutrition education, and breastfeeding support for pregnant women and children under age 5. If you receive Medicaid, you automatically meet the income requirements for WIC. Contact your local WIC office to enroll.
Frequently Asked Questions
How long does it take to get approved for Medicaid in New York?
Many applicants receive an immediate eligibility determination when applying online through NY State of Health. If additional verification is needed, processing typically takes 10 to 45 days. Pregnant women and children often receive expedited processing. Coverage can be backdated up to three months to cover medical expenses incurred before approval.
Can I apply for Medicaid in New York if I am employed?
Yes. New York Medicaid covers working adults whose income falls below 138% of the federal poverty level. A single person can earn up to $21,597 per year and still qualify. Many people with part-time or even full-time jobs receive Medicaid because their wages fall below the income limits.
Does New York Medicaid have an asset limit?
For most applicants, no. Adults, children, and pregnant women applying under MAGI rules have no asset limits. You will not be disqualified for having savings, owning a home, or having a car. Only seniors and people with disabilities applying for Community Medicaid face asset limits, which are $32,396 for individuals in 2025.
Can I apply for Medicaid if I am not a U.S. citizen?
Some non-citizens qualify for full Medicaid in New York. Lawful permanent residents, refugees, asylees, and certain other immigration categories can receive coverage. Undocumented immigrants may qualify for Emergency Medicaid to cover emergency medical conditions. Pregnant women may qualify for coverage regardless of immigration status in some cases. Immigration rules are complex, so consult an immigration attorney if you have concerns.
What if my income is just above the Medicaid limit?
New York offers the Essential Plan for residents earning between 138% and 250% of poverty. This program provides comprehensive coverage with $0 monthly premiums for most members and low copays. If your Medicaid application shows income above the limit, you may be automatically enrolled in the Essential Plan through NY State of Health.
How do I renew my Medicaid coverage?
Medicaid coverage must be renewed annually. New York will send you a renewal notice before your coverage period ends. Many renewals can be completed online through NY State of Health or mybenefits.ny.gov. If your circumstances have not changed, renewal often requires minimal effort. Respond to renewal notices promptly to avoid gaps in coverage.
Next Steps
If your income falls below the limits and you need health coverage, applying for Medicaid in New York is straightforward. Adults can qualify with income up to $21,597 for a single person or $44,367 for a family of four. Coverage includes doctor visits, hospital care, prescriptions, and preventive services at little to no cost.
Start by checking your eligibility using a free screening tool to see if you qualify for Medicaid and other programs. Then gather your documents and apply online through NY State of Health at nystateofhealth.ny.gov. The application takes about 30 to 45 minutes, and many applicants receive an immediate eligibility determination.
Over 7 million New Yorkers rely on Medicaid for their health coverage. The program exists to ensure residents can access healthcare regardless of their financial situation. Do not assume you will not qualify until you check.
