Under 65 & Not on Medicare (MAGI)

Income and Resource Limits for New York State Public Health Insurance Programs

INTRODUCTION AND NEWS ALERTS Feb. 13, 2026 UPDATE - NYS DOH announced the 2026 limits are in effect for Medicaid GIS 26 MA/05 - 2026 Federal Poverty Levels (PDF) GIS 26 MA/05 - 2026 Federal Poverty Levels Chart Since Jan. 1, 2023, the income limit for the Aged, Blind and...

"MAGI" Medicaid Eligibility under the Affordable Care Act - Rules for Most People Under age 65 Without Medicare

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...

NYS Directives on Medicaid changes under the Affordable Care Act

The New York State Department of Health (DOH) has issued additional directives outlining the new procedures for Medicaid applications and renewals under the Affordable Care Act, effective in 2014. For NYC directives click here. UPDATES Effective July 1, 2026 - Adults (above age 19) with MAGI...

2026 UPDATE: Elimination of Requirement to Apply for Social Security and Maximize Other Benefits for Medicaid & MSP

As of December 23, 2025, 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...

Keeping Medicaid after Cash Public Assistance or SSI Benefits Are Terminated

Scenarios: Susie is 49 years old and single, with no children. She has been receiving cash public assistance and Medicaid for three years, while she appeals the denial of Social Security Disability Insurance Benefits ("SSD" or "DIB"). She finally was approved for SSD, and will start receiving...

What You Need to Know About Lump Sum Payments and Medicaid Eligibility

By the Legal Aid Society Introduction Information about receiving a lump sum payment from Medicaid and how it may affect your eligibility or coverage. If I receive a lump sum payment, like a court settlement, workers’ compensation payment, or inheritance, will it affect my Medicaid coverage? ...

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...

Affordable Care Act --New York State Health Exchange Open Year-Round for Medicaid Applications and for Certain "Special Enrollment" categories

New York State of Health Exchange https://nystateofhealth.ny.gov/ MEDICAID Individuals eligible for Medicaid or Child Health Plus and American Indians/Alaskan Natives can enroll at any time during the year on the New York State of Health website. This is for people under age 65 who do not...