Get DOH-4495A 2010-2024

You can sign up any time to be pre-approved in case you have a future emergency. If you enroll in advance, you will be approved for the costs of future emergencies for 12 months. If you are under 65, you can enroll online. Visit the NY State of Health at nystateofhealth.gov, or call 1-855-355-5777.

Enrollment Assistors offer free personalized help. To speak with the Marketplace Customer Service Center call (855) 355-5777 (TTY: 1-800-662-1220)

Getting Your Medicaid ID Number If you aren't sure what your Medicaid ID number is, you can get this information from Health and Human services either in-person or over the phone by providing them with your identifying information along with a photo ID.

In approximately half of the states, ABD Medicaid's income limit is $914 / month for a single applicant and $1,371 for a couple. In the remaining states, the income limit is generally $1,215 / month for a single applicant and $1,643 / month for a couple.

(Supplement to Access NY Health Care Application DOH-4220) This Supplement must be completed if anyone who is applying is: • Age 65 or older • Certified blind or certified disabled (of any age) • Not certified disabled but chronically ill • Institutionalized and applying for coverage of nursing home care.

Call the HRA Medicaid Helpline at 888-692-6116 for more information.

NY Medicaid benefits cover regular exams, immunizations, doctor and clinic visits, relevant medical supplies and equipment, lab tests and x-rays, vision, dental, nursing home services, hospital stays, emergencies, and prescriptions.

New York State Medicaid New York's Medicaid program provides comprehensive health coverage to more than 7.3 million lower-income New Yorkers (as of December, 2021.)