Medicaid Coverage Extended to Individuals Age 65+ without Documentation
Effective January 1, 2024, New York State is waiving the citizenship/immigration requirements for Medicaid coverage for residents who are age 65 or older, as long as they meet all other eligibility criteria. Prior to this change, this population was only eligible for Medicaid to treat an emergency medical condition (also known as Emergency Medicaid).
Coverage will only be offered through mainstream Medicaid Managed Care plans (not HARP, HIV-SNP or MLTC). Prescription drug coverage is “carved out” and accessed through the Medicaid pharmacy NYRx program, as it is for all Medicaid beneficiaries.
Individuals 65 or older, who were enrolled in Emergency Medicaid prior to January 1, 2024, who are now eligible for “full” Medicaid, should have received notices in the mail regarding the benefit change and the need to select a managed care plan.. If they did not select a plan, they will be enrolled in a plan automatically. Individuals who want to maintain Emergency Medicaid coverage can opt out of this more comprehensive Medicaid coverage.
Individuals 65+ without documentation who are not enrolled in Emergency Medicaid and want to apply for Medicaid coverage can complete a paper application or apply online using ACCESS HRA.
Applying with a paper application: The DSS-4220 application and Supplement A must be submitted to the Local Department of Social Services (LDSS), which in NYC is the Human Resources Administration ( HRA).It can also be submitted at the Medicaid office, mailed, or completed with the assistance of a Facilitated Enroller.
Applying through ACCESS HRA: Individuals must create an account to begin their application.
Once the application is processed by the LDSS, the case will be transferred to NY State of Health and the individual can select a managed care plan or be auto-enrolled in a plan. All renewals will be handled by NY State of Health.
Clients in need of assistance applying for Medicaid can contact the Community Service Society’s Community Health Advocates at 888-614-5400.
