New York State Medicaid Program & Eligibility
Coverage, eligibility, and how to get Medicaid help in New York.
Medicaid Expansion
State Coverage
Medicaid in New York
NY Medicaid Eligibility
You may be eligible for Medicaid in New York if you live in the state and meet income and household requirements. New York is a Medicaid expansion state, so many adults qualify based on income alone.
You may qualify if you are:
- An adult ages 19–64
- A child or teenager
- Pregnant
- Age 65 or older
- Living with a disability
Some immigration groups, including children and pregnant individuals, may be eligible regardless of status.
Income Requirements
Medicaid income limits in New York depend on your household size and category.
In general:
- Adults under 65 qualify up to 138% of the Federal Poverty Level.
- Children and pregnant individuals qualify with income up to 218% of the poverty level.
- Seniors and people with disabilities may have different income and asset rules.
Income limits can change each year, so it's important to review current guidelines before applying. You can also visit the New York State of Health website to find out if you're financially eligible.
Applying for Medicaid
You can apply for Medicaid in New York in several ways, depending on your situation.
- Adults under 65 apply through the New York State of Health Marketplace.
- Seniors (65+) and people with disabilities apply through their local Department of Social Services.
Applications can be submitted online, by phone, by mail, or in person. Free application help is available in multiple languages.
After Applying
After you apply, New York will review your information and notify you of your Medicaid eligibility.
If approved:
- Coverage may start right away or be retroactive
- You'll usually enroll in a Medicaid managed care plan
- You'll need to renew coverage each year, and you can renew through the New York State of Health website as well.
Make sure to report any income or household changes promptly to avoid losing coverage.
What’s Covered
Doctor and Hospital Visits
Preventative Care and Screenings
Mental Health and Substance Use Treatment
Prescription Drugs
Maternity and Newborn Care
Dental and Vision Services
Long-Term Care (for eligible individuals)
Emergency Transportation Services
Need help with Medicaid in New York?
Below are some of the most commonly asked questions.
Medicaid in New York is a public health insurance program that provides free or low-cost health coverage to eligible low-income individuals and families. It is jointly funded by the federal government and New York State and is administered by the New York State Department of Health.
You may qualify for New York Medicaid if you live in New York State and meet certain income and residency requirements. Medicaid covers:
- Adults with low income
- Children and teens
- Pregnant individuals
- Seniors (age 65+)
- People with disabilities
Eligibility is primarily based on household size and income, but other factors like age, pregnancy, or disability status can matter.
How you apply depends on your age and situation:
- Adults under 65 typically apply through the New York State of Health Marketplace
- Seniors (65+) and people with disabilities usually apply through their local Department of Social Services (LDSS)
Applications can be submitted online, by phone, by mail, or in person.
Filling out government forms (paper or digital) can be confusing. We know the anxiety of missing important mail from the state. We built Fortuna to take the stress out of health plan coverage.
We provide your own dedicated navigator available by phone and chat to help you out!
For most people, Medicaid in New York has no monthly premium and very low or no out‑of‑pocket costs. Some services may require small copayments, but many groups (such as children and pregnant individuals) are exempt.
Medicare is health insurance that generally covers people aged 65+. Medicaid covers people of all ages if you make below a certain income or face hardship based on other circumstances like disability.
Fortuna focuses on Medicaid. If you need Medicare support, we can help you enroll onto a Medicare-Medicaid program.
Yes, if Fortuna is available through our partner health plan and providers. Please contact your insurer or provider for more information.
Yes, Fortuna is only available through providers and insurers. Please contact us at info@fortunahealth.com for more information.
Ready to renew or start your coverage?
Take the next step and keep your Medicaid benefits active with Fortuna’s simple, guided process.
