Get Doh 4220 Fillable Form

Are a New York State resident. Meet income eligibility requirements. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400) Are U.S. citizens or meet immigration status requirements.

The range would be $27,750 to $111,000 in 2022 for a family of four. (Income limits may be higher in Alaska and Hawaii because the federal poverty level is higher in those states.) The American Rescue Plan Act of 2021 also extended subsidy eligibility to some people earning more than 400% of the federal poverty level.

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 • 19 Jan 2023

Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Each month in which you need Medicaid services, bring in, send or fax (if available in your county) your paid or unpaid medical bills to your local department of social services. Only send these bills when they are equal to or more than the amount of your excess income.

UPDATE on 2/22/2023: The New York State Department of Health has published the official Medicaid income eligibility levels. These levels have been raised to 138% of the FPL, which is the Federal Poverty Level. Individual income levels for 2023 are now $1677 monthly/$20,121 yearly and for couples $2268 monthly/$27,214.

There is no monthly premium for families whose income is less than 2.2 times the poverty level. That's about $1150 a week for a three-person family, about $1387 a week for a family of four.

UPDATE on 2/22/2023: The New York State Department of Health has published the official Medicaid income eligibility levels. These levels have been raised to 138% of the FPL, which is the Federal Poverty Level. Individual income levels for 2023 are now $1677 monthly/$20,121 yearly and for couples $2268 monthly/$27,214.

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