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  • Bc Blue Shield Ny Child Health Plus Renewal Forms

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NCE RENEWAL FORM Legal Name (First, Middle Initial, Last) 1 Date of Birth Relationship to Person in Box 01 Self (Spouse, Child) (mm/dd/yy) 3 2 (Yes/No) (Yes/No) Female) (Yes/No) SEND PROOF 7 Is this Person Pregnant? (Yes/No) Full Time Student? 8 (XXX-XX-XXXX) Social Security Number (If you have one) 9 U.S. Citizen None of these apply Non-immigrant (Visa Holder) Immigrant DOS: / / U.S. Citizen None of these apply Non-immigrant (Visa Holder) Immigrant DOS:.

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METHODS: BY PHONE: Call our Member Services line at 855-456-9126 and ask to be connected to our Medicaid Recertification Department. The Medicaid Recertification specialist will be able to help you to fill out your forms and submit them directly online through a secure Web Portal to NYC HRA.

That's about $1150 a week for a three-person family, about $1387 a week for a family of four. Families with somewhat higher incomes pay a monthly premium of $15, $30, $45, or $60 per child per month, depending on their income and family size. For larger families, the monthly fee is capped at three children.

You can also renew by contacting the NY State of Health. Visit nystateohealth.ny.gov/individual to sign in to your account to view your renewal information or call 855-355-5777 (TTY: 800-662-1220) to ask questions.

Call us at 1-888-809-8009 (TTY 711), or visit a local Community Service Center to get free, in-person help. You can also renew by calling New York State of Health at 1-855-355-5777 (TTY 1-800-662-1220) or visiting .nystateofhealth.ny.gov.

Income & Asset Limits for Eligibility 2023 New York Medicaid Long Term Care Eligibility for SeniorsType of MedicaidSingleMarried (both spouses applying)Income LimitAsset LimitInstitutional / Nursing Home Medicaid$1,677 / month*$40,820Medicaid Waivers / Home and Community Based Services$1,677 / month†$40,8201 more row • Jan 19, 2023

Starting in Spring 2023, New York State will resume eligibility reviews and renewals for people enrolled in these programs. This means you may need to take action to renew your health insurance or the insurance of your family members.

Due to requirements in federal law and other flexibilities, NY State of Health has kept you enrolled in Medicaid, Child Health Plus, or the Essential Plan without requiring you to renew your insurance every year.

If you want to recertify for Medicaid and PA, check (✓) the “Medicaid (MA) and PA” box. If you wish to only recertify for MA, you can go online at https://nystateofhealth.ny.gov/ or call 1-855-355- 5777 for more information or to recertify.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232